INDEPENDENT LIVING CENTER OF SOUTHEAST MISSOURI (NPI# 1295867521) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1295867521 |
| Entity Type | Organization |
| Organization Name | INDEPENDENT LIVING CENTER OF SOUTHEAST MISSOURI |
| Practice Address |
511 Cedar St Poplar Bluff MO 63901-7301 |
| Practice Telephone | 5736862333 |
| Practice Fax Number | 5736861641 |
| Mailing Telephone | 5736862333 |
| Mailing Fax Number | 5736861641 |
| Enumeration Date | 2007-03-12 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MR. BRUCE D LYNCH (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 5736862333 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251B00000X | Case Management | MO | Agencies |
| Street Address |
511 CEDAR ST |
| City | POPLAR BLUFF |
| State | MO |
| Zip Code | 63901-7301 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720152077 | Independent Living Center of Southeast Missouri, Inc. | Case Management | 511 Cedar St, Poplar Bluff, MO 63901-7301 | 2006-11-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568076701 | Alternative Sleep Solution | Dentist | 2700 Kanell Blvd., Poplar Bluff, MO 63901 | 2020-09-04 |
| 1285271239 | Front Door Wellness LLC | Physical Therapist | Front Door Wellness LLC, 5835 Quail Meadows Drive, Poplar Bluff, MO 63901 | 2019-12-09 |
| 1104470368 | Andrew Akindutire | Dentist | 3101 Oak Groove Rd., Suite 6, Poplar Bluff, MO 63901 | 2019-07-26 |
| 1780195966 | Midwest Equipment Srv Systems LLC | Technician, Pathology | 2400 Lucy Lee Parkway, Suite C, Poplar Bluff, MO 63901 | 2017-10-16 |
| 1801259387 | Richard Justin Huber | Technician, Other | 3005 Warrior Ln, Poplar Bluff, MO 63901 | 2016-04-01 |
| 1699136275 | Donja Kirkland | Recreation Therapist | 1910a Greenwood Dr., Suite D, Poplar Bluff, MO 63901 | 2016-03-10 |
| 1760866867 | Bio-medical Applications of Missouri, Inc. | Clinic/Center | 3050 Tucker Road, Poplar Bluff, MO 63901 | 2015-07-17 |
| 1407246390 | Lisa Marie Payne | Physical Therapist | 4358c Highway Pp, Poplar Bluff, MO 63901 | 2015-01-29 |
| 1700202488 | Missouri Dental Professionals, Richard Straus, Dmd, PC | Dentist | 1602 W. Harper Street, Poplar Bluff, MO 63901 | 2014-03-05 |
| 1932521648 | Essential Family Healthcare, LLC | Clinic/Center | 1369 North Westwood Blvd., Poplar Bluff, MO 63901 | 2014-01-15 |
| Find all providers in zip 63901 | ||||
| Taxonomy Code | 251B00000X |
| Grouping | Agencies |
| Classification | Case Management |
| An organization that is responsible for providing case management services. The agency provides services which assist an individual in gaining access to needed medical, social, educational, and/or other services. Case management services may be used to locate, coordinate, and monitor necessary appropriate services. It may be used to encourage the use of cost-effective medical care by referrals to appropriate providers and to discourage over utilization of costly services. Case management may also serve to provide necessary coordination of non-medical services such as vocational rehabilitation, education, employment, when the services provided enable the individual to function at the highest level. |
| Notes: Source: CMS State Medicaid Manual Section 4442.3 [7/1/2006: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063582708 | State of Missouri | Case Management | 2351 Kanell Blvd, Poplar Bluff, MO 63901-4035 | 2006-11-09 |
| 1720152077 | Independent Living Center of Southeast Missouri, Inc. | Case Management | 511 Cedar St, Poplar Bluff, MO 63901-7301 | 2006-11-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376157644 | Kristin Keppler | Case Management | 221 Olga St, Saint James, MO 65559-1819 | 2020-09-03 |
| 1164036638 | Rebecca Jane Krewson | Case Management | 15183 Highway C, Lenox, MO 65541-9316 | 2020-09-02 |
| 1104440072 | Beyond Vision Mental Health Inc | Case Management | 140 Long Rd Ste 123, Chesterfield, MO 63005-1282 | 2020-06-05 |
| 1003446535 | Lana Smith | Case Management | 6710 N Bellefontaine Ave, Kansas City, MO 64119-1184 | 2020-01-23 |
| 1417501263 | Black Health Care Coalition | Case Management | 6400 Independence Ave, Kansas City, MO 64125-1545 | 2019-07-30 |
| 1386122497 | D&n Services Unlimited | Case Management | 1851 Arrowpoint Dr, Saint Louis, MO 63138-1515 | 2018-07-31 |
| 1689164980 | Diversity Placement Services, Inc. | Case Management | 905b E Langsford Rd Ste B, Lees Summit, MO 64063-2969 | 2018-05-14 |
| 1205325131 | Restoration of Hope Project | Case Management | 1925 E Bennett St Ste H, Springfield, MO 65804-1425 | 2018-05-07 |
| 1457855918 | Reynolds County Sheltered Workshop, Inc. | Case Management | 133 Highway 72 E, Bunker, MO 63629-8196 | 2018-03-20 |
| 1952800427 | The Community Counseling & Housing Services | Case Management | 10069 Tappan Dr, Saint Louis, MO 63137-2049 | 2018-02-09 |
| Find all providers with the same taxonomy | ||||
| City | POPLAR BLUFF |
| Zip Code | 63901 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.