Organization
SOUTHWEST CENTER FOR INDEPENDENT LIVING
Active
Other names
empower: abilities
Organization subpart
No
Provider details
NPI number
Authorized official
SHANNON MARIE PORTER (CEO)
(417) 886-1188
Entity
Organization
Contact information
Practice address
1450 W CAMBRIDGE ST, SPRINGFIELD, MO 65807-3726
(417) 886-1188
(417) 886-3619
Mailing address
1450 W CAMBRIDGE ST, SPRINGFIELD, MO 65807-3726
(417) 886-1188
(417) 886-3619
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
—
—
253Z00000X
In Home Supportive Care Agency
Primary
—
—
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
—
—
372500000X
Chore Provider
—
—
3747P1801X
Personal Care Attendant
—
—
376J00000X
Homemaker
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
266213800
—
MO
Enumeration date
07/14/2006
Last updated
05/02/2024
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