National Provider Identifier Database

INDEPENDENT LIVING CENTER OF MID MISSOURI INC
Specialist

An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.


Contact Information

INDEPENDENT LIVING CENTER OF MID-MISSOURI INC.
1401 HATHMAN PL
COLUMBIA, MO65201-5552
Phone: 573-874-1646
Fax: 573-874-3564
Website:
Specialty Taxonomy Code
* Specialist 174400000X
In Home Supportive Care 253Z00000X
Personal Care Attendant 3747P1801X
Supports Brokerage 251X00000X

* Indicates primary specialty

NPI Profile & details for INDEPENDENT LIVING CENTER OF MID-MISSOURI INC.

NPI Number 1619914538
Legal business name
LBN
INDEPENDENT LIVING CENTER OF MID-MISSOURI INC.
Authorized official PATRICK LEE - (EXECUTIVE DIRECTOR)
Entity Organization
Organization subpart No
Enumeration date 05/31/2006
Last updated 03/22/2022 - About 4 years ago
Sole proprietor1 Not specified
Identifiers
  • MO Medicaid: 266211309

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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