Northeast Independent Living Services
Northeast Independent Living Services is a PACE Provider Organization in Hannibal, Missouri. Licensed in Missouri. Registered with an NPI since 2009.
- Licensed in
- MO
- In the registry since
- 2009
Practice location Address checks out
909 Broadway Ste 350Hannibal, MO 63401-4249
Phone: (573) 221-8282
Fax: (573) 221-8233
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| PACE Provider Organization (primary) | Taxonomy 251T00000X · Licence 834 (MO) |
|---|
Record details
| NPI number | 1861622128 |
|---|---|
| Entity type | Organization (Type 2) |
| Organization subpart | No |
| Authorized official | Tara Fortner — Payroll Billing Manager · (573) 221-8282 |
| Other names | Magnolia Garden Adult Daycare |
| NPI enumerated | July 21, 2009 |
| Last updated in NPPES | July 21, 2009 |
| Mailing address | 909 Broadway, Suite 350, Hannibal, MO 63401-4249 |