COMMUNITY LIVING OPTIONS INC NPI 1306018437

NPI Information

COMMUNITY LIVING OPTIONS INC is an intermediate care facility mentally retarded in Springfield, IL. The provider is (1) A public institution for care of the mentally retarded or people with related conditions. (2) An institution giving active treatment to mentally retarded or developmentally disabled persons or persons with related conditions. The primary purpose of the institution is to provide health or rehabilitative services to such individuals. COMMUNITY LIVING OPTIONS INC NPI is 1306018437. The provider is registered as an organization entity type.
The provider Is Doing Business As Gaines Mill Place.

The provider's business location address is:

3310 GAINES MILL RD
SPRINGFIELD, IL
ZIP 62704-709
Phone: (217) 793-0075
Fax: (217) 793-0071

The provider's authorized official is Ronald J Wilson .
The authorized official title is Authorized Agent and has the following contact phone number (309) 343-1550.

The enumeration date for this NPI number is 3/28/2008 and was last updated on 4/20/2008.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

Other Identifiers

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