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Organization

INDEPENDENT LIVING CENTER OF MID-MISSOURI INC.

Active
Other names
Services for Independent Living
Organization subpart
No

Provider details

NPI number
Authorized official
MR. PATRICK LEE (EXECUTIVE DIRECTOR)
(573) 874-1646
Entity
Organization

Contact information

Practice address
1401 HATHMAN PL, COLUMBIA, MO 65201-5552
(573) 874-1646
(573) 874-3564
Mailing address
1401 HATHMAN PL, COLUMBIA, MO 65201-5552
(573) 874-1646
(573) 874-3564

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
251X00000X
Supports Brokerage Agency
253Z00000X
In Home Supportive Care Agency
3747P1801X
Personal Care Attendant

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
266211309
MO
Enumeration date
05/31/2006
Last updated
03/22/2022
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