NPIMap

Organization Active NPI

Community Living, Inc

  • Intellectual and/or Developmental Disabilities Residential Treatment Facility
  • Butler, IN
National Provider Identifier
1346280765
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual and/or Developmental Disabilities Residential Treatment FacilityTaxonomy code 320600000X
License
2511I0005DE07 Issued in IN
Legal business name
COMMUNITY LIVING, INC
Practice address
417 N Ash St
Butler, IN 46721-1105
Phone
(260) 665-7681
Fax
(260) 665-1501
NPI assigned
Jun 7, 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 Residential Treatment Facility 320600000X 2511I0005DE07 IN Primary

Addresses

Primary practice location

417 N Ash St
Butler, IN 46721-1105

Mailing address

PO Box 6
Angola, IN 46703-0006
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.

NPI Registry JSON

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

{
    "created_epoch": "1149638400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1346280765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6",
            "city": "ANGOLA",
            "state": "IN",
            "postal_code": "467030006",
            "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": "417 N ASH ST",
            "city": "BUTLER",
            "state": "IN",
            "postal_code": "467211105",
            "telephone_number": "260-665-7681",
            "fax_number": "260-665-1501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY LIVING, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-07",
        "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": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "IN",
            "license": "2511I0005DE07",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Butler, 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.