Community Living Options INC

NPI #1447422373 in Jacksonville, Illinois

Provider Information

NPI Number
1447422373
Entity Type
Organization
Organization Name
Community Living Options INC
Subpart
Yes (part of a larger organization)
Parent Organization
COMMUNITY LIVING OPTIONS INC
Primary Specialty
Intermediate Care Facility, Intellectual Disabilities
Enumeration Date
Apr 1, 2008
Last Updated
Apr 20, 2008

Practice Location

Address
408 ANNA STREET
ZIP Code
62650-2847
Phone
(217) 245-5566

Authorized Official

Name
MR. RONALD J WILSON
Title
AUTHORIZED AGENT
Phone
(309) 343-1550

Specialties & Taxonomy Codes

Specialty
Intermediate Care Facility, Intellectual Disabilities

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