Organization
MIDWEST INDEPENDENT LIVING SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. LISA MARIE SELLY (OWNER)
(952) 456-8064
Entity
Organization
Contact information
Practice address
809 EAST MAIN STREET, SUITE 1, BELLE PLAINE, MN 56011
(952) 456-8064
(952) 322-7167
Mailing address
809 EAST MAIN STREET, SUITE 1, BELLE PLAINE, MN 56011
(952) 456-8064
(952) 322-7167
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
—
—
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Enumeration date
03/30/2011
Last updated
10/03/2018
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