Organization
NORTHEAST INDEPENDENT LIVING SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JACKLIN KENDRICK (EXECUTIVE DIRECTOR)
(573) 221-8282
Entity
Organization
Contact information
Practice address
4500 PARIS GRAVEL RD, HANNIBAL, MO 63401-5422
(573) 221-8282
(573) 221-9445
Mailing address
4500 PARIS GRAVEL RD, HANNIBAL, MO 63401-5422
(573) 221-8282
(573) 221-9445
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
—
—
Other
Enumeration date
10/30/2023
Last updated
10/30/2023
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