Community Living, INC

NPI #1720021512 in Angola, Indiana

Provider Information

NPI Number: 1720021512
Entity Type: Organization
Organization Name: Community Living, INC
Primary Specialty: Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Enumeration Date: Jun 13, 2006
Last Updated: Aug 22, 2020

Practice Location

Address: 1102 W MILL ST
City: Angola
State: Indiana
ZIP Code: 46703-1344
Phone: (260) 665-7681

Authorized Official

Name: MR. RANDY THIEBAUT
Title: PRESIDENT
Phone: (260) 665-7681

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Residential Treatment Facility, Intellectual and/or Developmental Disabilities	320600000X	Primary

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