NPIMap

Organization Active NPI

Community Living Options Inc

  • Intellectual Disabilities Intermediate Care Facility
  • Freeburg, IL
National Provider Identifier
1205008653
Registry record updated Apr 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual Disabilities Intermediate Care FacilityTaxonomy code 315P00000X
License
36582 Issued in IL
Legal business name
COMMUNITY LIVING OPTIONS INC
Practice address
#4 Hill Mine Road
Freeburg, IL 62243-3225
Phone
(618) 539-4882
Fax
(618) 539-4895
NPI assigned
Mar 26, 2008
Organization subpart
Yes
Parent organization
COMMUNITY LIVING OPTIONS INCAs reported in NPPES

Authorized official

NPPES NPI Registry
Name
Mr. Ronald J Wilson
Title
Authorized Agent
Phone
(309) 343-1550

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Corporate family (same tax ID) 39

Organizations that report the same tax identification number in the National Provider Directory.

View all 39

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

National Provider Directory

National Provider Directory
Tax ID family
Community Living Options Inc (40 organizations share this tax ID)
Part of
Community Living Options Inc

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual Disabilities Intermediate Care Facility 315P00000X 36582 IL Primary

Addresses

NPPES NPI Registry

Primary practice location

#4 Hill Mine Road
Freeburg, IL 62243-3225

Mailing address

285 South Farnham Street
Galesburg, IL 61401-5323
Phone (309) 343-1550

Other names 1

NPPES NPI Registry
  • Freeburg Terrace Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Apr 20, 2008.

{
    "created_epoch": "1206489600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208649600000",
    "number": "1205008653",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "285 SOUTH FARNHAM STREET",
            "city": "GALESBURG",
            "state": "IL",
            "postal_code": "614015323",
            "telephone_number": "309-343-1550",
            "fax_number": "309-343-6318"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "#4 HILL MINE ROAD",
            "city": "FREEBURG",
            "state": "IL",
            "postal_code": "622433225",
            "telephone_number": "618-539-4882",
            "fax_number": "618-539-4895"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY LIVING OPTIONS INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "COMMUNITY LIVING OPTIONS INC",
        "enumeration_date": "2008-03-26",
        "last_updated": "2008-04-20",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "RONALD",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "AUTHORIZED AGENT",
        "authorized_official_telephone_number": "309-343-1550",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "315P00000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Intellectual Disabilities",
            "state": "IL",
            "license": "36582",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Freeburg Terrace",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Freeburg, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.