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) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 09M012 | Other | IL | LICENSE |
Other names
- CIL, Inc.
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All providers in Anna, IL · Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 16, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.