Midwest Independent Living Services, LLC

Primary specialty

In Home Supportive Care AgencyTaxonomy code 253Z00000X

Legal business name

MIDWEST INDEPENDENT LIVING SERVICES, LLC

Practice address

809 East Main Street
Suite 1
Belle Plaine, MN 56011

Phone

(952) 456-8064

Fax

(952) 322-7167

NPI assigned

Mar 30, 2011

Last updated

Oct 3, 2018By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ms. Lisa Marie Selly

Title

Owner

Phone

(952) 456-8064

Specialties & licenses 2

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1301443200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1538524800000",
    "number": "1033408075",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "809 EAST MAIN STREET",
            "address_2": "SUITE 1",
            "city": "BELLE PLAINE",
            "state": "MN",
            "postal_code": "56011",
            "telephone_number": "952-456-8064",
            "fax_number": "952-322-7167"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "809 EAST MAIN STREET",
            "address_2": "SUITE 1",
            "city": "BELLE PLAINE",
            "state": "MN",
            "postal_code": "56011",
            "telephone_number": "952-456-8064",
            "fax_number": "952-322-7167"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIDWEST INDEPENDENT LIVING SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-03-30",
        "last_updated": "2018-10-03",
        "status": "A",
        "authorized_official_last_name": "SELLY",
        "authorized_official_first_name": "LISA",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "952-456-8064",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• In Home Supportive Care Agency in Belle Plaine, MN
• Providers in Belle Plaine, MN by specialty
• In Home Supportive Care Agency in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.