Organization · Type 2 NPI
Community Living Options Inc
Intellectual Disabilities Intermediate Care Facility · Jerseyville, IL
NPI number
1962674317
Active
Practice location
301 Maple Summit Road
Jerseyville, IL 62052-2003
Fax (618) 498-9285
Mailing address
285 South Farnham Street
Galesburg, IL 61401-5323
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Intellectual Disabilities Intermediate Care Facility Primary | 315P00000X | 32151 (IL) |
Intellectual Disabilities Intermediate Care Facility: An intermediate care facility providing services for individuals with intellectual disabilities.
About NPI 1962674317
Community Living Options Inc's National Provider Identifier is 1962674317, issued on Mar 26, 2008. The primary taxonomy on file is Intellectual Disabilities Intermediate Care Facility (315P00000X), and the practice location is in Jerseyville, IL. The record was last updated on Apr 20, 2008.