Organization · Type 2 NPI

Community Living Options Inc

Intellectual Disabilities Intermediate Care Facility · Springfield, IL

NPI number 1306018437 Active

Practice location

3310 Gaines Mill Rd
Springfield, IL 62704-5709

Call (217) 793-0075 Map

Fax (217) 793-0071

Mailing address

285 South Farnham Street
Galesburg, IL 61401-5323

Specialties and licenses

Taxonomy	Code	License
Intellectual Disabilities Intermediate Care Facility Primary	315P00000X	35055 (IL)

Intellectual Disabilities Intermediate Care Facility: An intermediate care facility providing services for individuals with intellectual disabilities.

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NPI record

NPI: 1306018437
Entity type: Organization (Type 2)
Issued: Mar 28, 2008
Last updated: Apr 20, 2008
Status: Active
Subpart: Yes of Community Living Options Inc

Other names

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Gaines Mill Place · doing business as

Authorized official

Mr. Ronald J Wilson
Authorized Agent
(309) 343-1550

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This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1306018437

Community Living Options Inc's National Provider Identifier is 1306018437, issued on Mar 28, 2008. The primary taxonomy on file is Intellectual Disabilities Intermediate Care Facility (315P00000X), and the practice location is in Springfield, IL. The record was last updated on Apr 20, 2008.