Community Living Options INC

NPI #1851563209 in Waterloo, Illinois

Provider Information

NPI Number
1851563209
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
98 DEBRA LANE
ZIP Code
62298-1479
Phone
(618) 939-3336

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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