Community Living Options INC

NPI #1760654115 in Alton, Illinois

Provider Information

NPI Number
1760654115
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
Mar 26, 2008
Last Updated
Apr 20, 2008

Practice Location

Address
4029 ABERDEEN STREET
City
Alton
ZIP Code
62002-3127
Phone
(618) 462-1515

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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