Organization · Type 2 NPI
Community Living Options Inc
Intellectual Disabilities Intermediate Care Facility · Wood River, IL
NPI number
1164694501
Active
Practice location
460 Pershing
Wood River, IL 62095-1316
Fax (618) 258-1641
Mailing address
285 South Farnham Street
Galesburg, IL 61401-5323
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Intellectual Disabilities Intermediate Care Facility Primary | 315P00000X | 39703 (IL) |
Intellectual Disabilities Intermediate Care Facility: An intermediate care facility providing services for individuals with intellectual disabilities.
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- Community Living Options IncIntellectual Disabilities Intermediate Care Facility Wood River, IL NPI 1922270057
About NPI 1164694501
Community Living Options Inc's National Provider Identifier is 1164694501, issued on Mar 26, 2008. The primary taxonomy on file is Intellectual Disabilities Intermediate Care Facility (315P00000X), and the practice location is in Wood River, IL. The record was last updated on Apr 20, 2008.