Community Integrated Living, Inc.

Organization Active NPI Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility · Anna, IL

NPI 1265711600 · NPPES record last updated Aug 16, 2011

Key facts

NPI
1265711600
Entity type
Organization (NPI type 2)
Primary specialty
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility 320900000X
License
09M012 (IL)
Legal business name
COMMUNITY INTEGRATED LIVING, INC.
Practice address
110 Jeni Lane
Anna, IL 62906
Phone
(618) 697-1122
Fax
(618) 833-1360
NPI assigned
Aug 16, 2011
Organization subpart
No

Authorized official

Name
Mr. Don J. Pippins, LNHA
Title
President
Phone
(618) 697-1122

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility 320900000X 09M012 IL Yes

Addresses

Primary practice location

110 Jeni Lane
Anna, IL 62906

Mailing address

2465 Lick Creek Rd
Anna, IL 62906-3269
Phone (618) 697-1122

Other identifiers

IdentifierTypeStateIssuer
09M012OtherILLICENSE

Other names

  • CIL, Inc. Doing business as

Other providers in Anna, IL

All providers in Anna, IL · Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Illinois

Sources for this page

Verify at the official NPI Registry.