COMMUNITY LIVING OPTIONS INC NPI 1114199569

NPI Information

  • NPI: 1114199569
  • Provider Name: COMMUNITY LIVING OPTIONS INC
  • Classification: Intermediate Care Facility, Intellectual Disabilities - 315P00000X
  • Entity Type: Organization
  • Doing Business As: BEARDSTOWN TERRACE
  • Address: 310 E EIGHT STREET
    BEARDSTOWN, IL
    ZIP 62618
  • Phone: (217) 323-5544

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NPI Details

COMMUNITY LIVING OPTIONS INC is an intermediate care facility mentally retarded in Beardstown, IL. The provider is an intermediate care facility providing services for individuals with intellectual disabilities. COMMUNITY LIVING OPTIONS INC NPI is 1114199569. The provider is registered as an organization entity type.
The provider Is Doing Business As Beardstown Terrace.

The provider's business location address is:

310 E EIGHT STREET
BEARDSTOWN, IL
ZIP 62618-853
Phone: (217) 323-5544
Fax: (217) 323-3331

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 3/26/2008 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:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1315P00000XIntermediate Care Facility, Intellectual Disabilities35766ILLINOISYes

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=========045MEDICAIDILLINOIS

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: 11/21/2025

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