NPIMap

Organization Active NPI

Community Living, Inc

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Angola, IN
National Provider Identifier
1316980774
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
Legal business name
COMMUNITY LIVING, INC
Practice address
2000 W 175 N
Angola, IN 46703-7117
Phone
(260) 665-7681
Fax
(260) 665-1501
NPI assigned
Jun 14, 2006
Last updated
Aug 22, 2020By the provider in NPPES
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
Mr. Randy Thiebaut
Title
President
Phone
(260) 665-7681

Specialties & licenses 1

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

Addresses

Primary practice location

2000 W 175 N
Angola, IN 46703-7117

Mailing address

PO Box 393
Angola, IN 46703-0393
Phone (260) 665-7681

National Provider Directory

National Provider Directory
Tax ID family
Community Living Inc7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

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

Locations

2060 W 175 N
Angola, IN 46703
Phone (260) 665-7681

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1150243200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1316980774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 393",
            "city": "ANGOLA",
            "state": "IN",
            "postal_code": "467030393",
            "telephone_number": "260-665-7681",
            "fax_number": "260-665-1501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 W 175 N",
            "city": "ANGOLA",
            "state": "IN",
            "postal_code": "467037117",
            "telephone_number": "260-665-7681",
            "fax_number": "260-665-1501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY LIVING, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-14",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "THIEBAUT",
        "authorized_official_first_name": "RANDY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "260-665-7681",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Angola, IN

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.