Independent Living Center of Southeast Missouri, Inc.

NPI #1720152077 in Poplar Bluff, Missouri

Provider Information

NPI Number: 1720152077
Entity Type: Organization
Organization Name: Independent Living Center of Southeast Missouri, Inc.
Primary Specialty: Case Management
Enumeration Date: Nov 20, 2006
Last Updated: Sep 14, 2021

Practice Location

Address: 511 CEDAR ST
City: Poplar Bluff
State: Missouri
ZIP Code: 63901-7301
Phone: (573) 686-2333

Authorized Official

Name: MRS. JENNIFER BROWN
Title: EXECUTIVE DIRECTOR
Phone: (573) 686-2333

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Nursing Care	251J00000X
In Home Supportive Care	253Z00000X
Case Management	251B00000X	Primary

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