Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Independent Living Center of Southeast Missouri, Inc

Organization Case Management Agency · NPI 1720152077

Independent Living Center of Southeast Missouri, Inc is a Case Management Agency in Poplar Bluff, Missouri. Licensed in Missouri. Registered with an NPI since 2006.

Licensed in
MO
In the registry since
2006
Specialties on file
3
What do these letters mean?
Inc — Incorporated
A form of business registration, not a clinical qualification.

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Practice location Address checks out

511 Cedar St
Poplar Bluff, MO 63901-7301
Phone: (573) 686-2333
Fax: (573) 686-1641
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Case Management Agency (primary) Taxonomy 251B00000X (MO)
Nursing Care Agency Taxonomy 251J00000X
In Home Supportive Care Agency Taxonomy 253Z00000X

Record details

NPI number1720152077
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Jennifer Brown — Executive Director · (573) 686-2333
NPI enumeratedNovember 20, 2006
Last updated in NPPESSeptember 14, 2021
Certification dateSeptember 14, 2021
Mailing address511 Cedar St, Poplar Bluff, MO 63901-7301

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