NPIMap

Organization Active NPI

Northeast Independent Living Services

Doing business as Quality In Home Care

  • Nursing Care Agency
  • Hannibal, MO
National Provider Identifier
1790948958
Registry record updated Oct 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nursing Care AgencyTaxonomy code 251J00000X
Legal business name
NORTHEAST INDEPENDENT LIVING SERVICES
Doing business as
Quality In Home Care
Practice address
4500 Paris Gravel Rd
Hannibal, MO 63401-5422
Phone
(573) 221-8282
Fax
(573) 221-8233
NPI assigned
Jul 8, 2008
Last updated
Oct 30, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2023

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

Authorized official

Name
Tara Lynn Fortner
Title
Finance Director
Phone
(573) 221-8282

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nursing Care Agency 251J00000X NU Primary

Addresses

Primary practice location

4500 Paris Gravel Rd
Hannibal, MO 63401-5422

Mailing address

909 Broadway Ste 350
Hannibal, MO 63401-4253
Phone (573) 221-8282

Other names 1

  • Quality In Home Care Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Northeast Independent Living Services5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1215475200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1698624000000",
    "number": "1790948958",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "909 BROADWAY STE 350",
            "city": "HANNIBAL",
            "state": "MO",
            "postal_code": "634014253",
            "telephone_number": "573-221-8282",
            "fax_number": "573-221-8233"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4500 PARIS GRAVEL RD",
            "city": "HANNIBAL",
            "state": "MO",
            "postal_code": "634015422",
            "telephone_number": "573-221-8282",
            "fax_number": "573-221-8233"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHEAST INDEPENDENT LIVING SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-08",
        "last_updated": "2023-10-30",
        "certification_date": "2023-10-30",
        "status": "A",
        "authorized_official_last_name": "FORTNER",
        "authorized_official_first_name": "TARA",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "FINANCE DIRECTOR",
        "authorized_official_telephone_number": "573-221-8282"
    },
    "taxonomies": [
        {
            "code": "251J00000X",
            "taxonomy_group": "",
            "desc": "Nursing Care",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Quality In Home Care",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Quality In Home Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Hannibal, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2023; 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.