Northeast Independent Living Services

LBN: Northeast Independent Living Services
Northeast Independent Living Services is an health care organization with primary practice located at 4500 Paris Gravel Rd , Hannibal MO 63401-5422. The organization recently has 6 registered licenses in different health care specialties including Agencies / Nursing Care, Agencies / Supports Brokerage, Agencies / In Home Supportive Care, Nursing Service Related Providers / Chore Provider, Nursing Service Related Providers / Homemaker, Respite Care Facility / Respite Care. Nursing Service Related Providers / Homemaker is the primary health care specialty. Northeast Independent Living Services can be contacted via phone (573) 221-8282, or through Fortner, Tara via phone (573) 221-8282.

Contact Information

Primary practice address
4500 Paris Gravel Rd Hannibal MO 63401-5422
Phone: (573) 221-8282
Fax: (573) 221-9445
Website:
Map and Directions
Authorized official contact:
Name: Fortner, Tara
Phone: (573) 221-8282

Health care specialties

SpecialtyCodeLicense #State
Agencies / Nursing Care 251J00000X
Agencies / Supports Brokerage 251X00000X
Agencies / In Home Supportive Care 253Z00000X
Nursing Service Related Providers / Chore Provider 372500000X
Nursing Service Related Providers / Homemaker 376J00000X
Respite Care Facility / Respite Care 385H00000X

Profile Details

NPI number 1457528085
LBN Legal business name Northeast Independent Living Services
DBA Doing business as
Authorized official Fortner, Tara
Entity Organization
Organization subpart 1 No
Enumeration date May 13th, 2008
Last updated Mar 8th, 2023 - about last year

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1457528085 NPPES
Missouri MEDICAID 266213701
Missouri MEDICAID 286213707

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