Organization
THE INDEPENDENT LIVING CENTER, INC.
Active
Parent organization
THE INDEPENDENT LIVING CENTER, INC.
Organization subpart
Yes
Provider details
NPI number
Legal business name
THE INDEPENDENT LIVING CENTER, INC.
Authorized official
STORMI L NORDSTROM (DIRECTOR OF OPERATIONS)
(417) 659-8086
Entity
Organization
Contact information
Practice address
2639 E 34TH ST, JOPLIN, MO 64804-4337
(417) 659-8086
(417) 659-8087
Mailing address
2639 E 34TH ST, JOPLIN, MO 64804-4337
(417) 659-8086
(417) 659-8087
Taxonomy
Speciality
Code
Description
License number
State
372500000X
Chore Provider
—
—
3747A0650X
Attendant Care Provider
Primary
—
—
3747P1801X
Personal Care Attendant
—
—
Other
Enumeration date
07/12/2016
Last updated
04/19/2023
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