Independent Living Center Of Southeast Missouri

NPI 1295867521 - Case Management - 251B00000X

NPI Details
NPI 1295867521
Enumeration Date 03/12/2007
Last Updated 07/09/2007
Entity Type Healthcare Provider
Active Over 9 years ago
Authorized Information
Name BRUCE D BRUCE
Position EXECUTIVE DIRECTOR
Phone (573) 686-2333
Fax (573) 686-1641
Practice Location
511 CEDAR ST
POPLAR BLUFF MO, 63901-7301, US
Phone (573) 686-2333
Fax (573) 686-1641
Business Location
511 CEDAR ST
POPLAR BLUFF MO, 63901-7301, US
Phone (573) 686-2333
Fax (573) 686-1641
Toxanomy
Taxonomy Code 251B00000X
License State
License Number
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According to our database, Independent Living Center Of Southeast Missouri NPI is 1295867521, taxonomy code is 251B00000X Independent Living Center Of Southeast Missouri physically located at 511 Cedar St, Poplar Bluff MO, 63901-7301. NPI Number 1033115704 has the healthcare provider type.

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1295867521 NPI number is provided on an as is basis without warranty of any kind. 1295867521 is maintained by the National Plan & Provider Enumeration System. The contents of Independent Living Center Of Southeast Missouri are for informational purposes only.