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14D2205704 CLIA NUMBER - COMMUNITY SUPPORT SYSTEMS

Laboratory Demographics

CLIA Number: 14D2205704

Facility Name: COMMUNITY SUPPORT SYSTEMS

Facility Address:
618 W MAIN ST
TEUTOPOLIS, IL
ZIP 62467
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Facility Phone Number: 217 705-4298

Facility Type: Other - COMMUNITY REHAB PROVIDER

Certificate Type: Waiver
NPI Number: 1215041991

Taxonomy: 251C00000X - Day Training, Developmentally Disabled Services
These agencies are authorized to provide day habilitation services to developmentally disabled individuals who live in their homes. The function of day habilitation is to assist an individual to acquire and maintain those life skills that enable the individual to cope more effectively with the demands of independent living. Also to raise the level of the individual's physical, mental, social, and vocational functioning.

CLIA Record

Field Name Field Value
CLIA Number 14D2205704
LAB Type Other - COMMUNITY REHAB PROVIDER
Facility Name COMMUNITY SUPPORT SYSTEMS
Street 618 W MAIN ST
City TEUTOPOLIS
State IL
ZIP 62467
Phone 217 705-4298
CertificateType 4
CertificateEffectiveDate 12/15/2022
CertificateExpirationDate 12/14/2024
FacilityType Waiver

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This page was last updated on: 4/23/2024