RESIDENTIAL OPTIONS INC. NPI 1104047174

NPI Information

NPI: 1104047174
Provider Name: RESIDENTIAL OPTIONS, INC.
Classification: Intermediate Care Facility, Intellectual Disabilities - 315P00000X
Entity Type: Organization
Address:
4617 WONDERLAND DR
ALTON, IL
ZIP 62002
Phone: (618) 465-8845
Get Directions

RESIDENTIAL OPTIONS, INC. is an intermediate care facility mentally retarded in Alton, IL. The provider is an intermediate care facility providing services for individuals with intellectual disabilities. RESIDENTIAL OPTIONS, INC. NPI is 1104047174. The provider is registered as an organization entity type.

The provider's business location address is:

4617 WONDERLAND DR
ALTON, IL
ZIP 62002-309
Phone: (618) 465-8845
Fax: (618) 463-4890

The provider's authorized official is Diane Tebbe .
The authorized official title is Vp and has the following contact phone number (618) 465-0044.

The enumeration date for this NPI number is 5/1/2007 and was last updated on 7/21/2022.

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:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	320900000X	Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities		0039123	ILLINOIS	No
2	315P00000X	Intermediate Care Facility, Intellectual Disabilities				Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	6013973	OTHER	ILLINOIS	PUBLIC HEALTH FACILITY ID

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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