NPIMap

Organization Active NPI

Residential Options

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Granite City, IL
National Provider Identifier
1316166382
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X
License
0036905 Issued in IL
Legal business name
RESIDENTIAL OPTIONS
Practice address
56 Chouteau Trace Pkwy
Granite City, IL 62040-6710
Phone
(618) 797-2262
Fax
(618) 797-2264
NPI assigned
Apr 25, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Susan L Stafstrom
Title
Accounting Manager
Phone
(618) 465-0044

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility 320900000X 0036905 IL Primary

Addresses

Primary practice location

56 Chouteau Trace Pkwy
Granite City, IL 62040-6710

Mailing address

56 Chouteau Trace Pkwy
Granite City, IL 62040-6710
Phone (618) 797-2262

Other identifiers 1

IdentifierTypeStateIssuer
6012793OtherILPUBLIC HEALTH FACILITY ID

National Provider Directory

National Provider Directory
Tax ID family
Residential Options Inc18 organizations share this tax ID, including this one

Other organizations with this tax ID 17

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

View all 17

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1177459200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1316166382",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "56 CHOUTEAU TRACE PKWY",
            "city": "GRANITE CITY",
            "state": "IL",
            "postal_code": "620406710",
            "telephone_number": "618-797-2262",
            "fax_number": "618-797-2264"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "56 CHOUTEAU TRACE PKWY",
            "city": "GRANITE CITY",
            "state": "IL",
            "postal_code": "620406710",
            "telephone_number": "618-797-2262",
            "fax_number": "618-797-2264"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RESIDENTIAL OPTIONS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-25",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "STAFSTROM",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "ACCOUNTING MANAGER",
        "authorized_official_telephone_number": "618-465-0044"
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "IL",
            "license": "0036905",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PUBLIC HEALTH FACILITY ID",
            "identifier": "6012793",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Granite City, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.