National Provider Identifier Database

NORTHEAST INDEPENDENT LIVING SERVICES
Homemaker

An individual who provides general household activities such as meal preparation, laundry, and light housekeeping, when the individual regularly responsible for these activities is temporarily absent or unable to provide for himself. Homemakers must meet the state defined training standards.


Contact Information

NORTHEAST INDEPENDENT LIVING SERVICES
4500 PARIS GRAVEL RD
HANNIBAL, MO63401-5422
Phone: 573-221-8282
Fax: 573-221-9445
Website:
Specialty Taxonomy Code
* Homemaker 376J00000X
Chore Provider 372500000X
In Home Supportive Care 253Z00000X
Nursing Care 251J00000X
Respite Care 385H00000X
Supports Brokerage 251X00000X

* Indicates primary specialty

NPI Profile & details for NORTHEAST INDEPENDENT LIVING SERVICES

NPI Number 1457528085
Legal business name
LBN
NORTHEAST INDEPENDENT LIVING SERVICES
Authorized official TARA FORTNER - (FINANCE DIRECTOR)
Entity Organization
Organization subpart No
Enumeration date 05/13/2008
Last updated 03/08/2023 - About 3 years ago
Sole proprietor1 Not specified
Identifiers
  • MO Medicaid: 266213701
  • MO Medicaid: 286213707

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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