Community Living, Inc
Organization Active NPI Intellectual and/or Developmental Disabilities Residential Treatment Facility · Angola, IN
NPI 1720021512 · NPPES record last updated Aug 22, 2020
Key facts
- NPI
- 1720021512
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Intellectual and/or Developmental Disabilities Residential Treatment Facility 320600000X
- Legal business name
- COMMUNITY LIVING, INC
- Practice address
- 1102 W Mill St
Angola, IN 46703-1344 - Phone
- (260) 665-7681
- Fax
- (260) 665-1501
- NPI assigned
- Jun 13, 2006
- Organization subpart
- No
Authorized official
- Name
- Mr. Randy Thiebaut
- Title
- President
- Phone
- (260) 665-7681
Corporate family (same tax ID) 6
National Provider Directory
- Tax ID family
- Community Living Inc
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Intellectual and/or Developmental Disabilities Residential Treatment Facility | 320600000X | IN | Yes |
Addresses
Primary practice location
1102 W Mill St
Angola, IN 46703-1344
Mailing address
PO Box 6
Angola, IN 46703-0006
Phone (260) 665-7681
Other providers in Angola, IN
- Jeanette Cochran
- Jessica Cole
- Community Living, Inc
- Community Living, Inc
- Community Living, Inc
- Jessica Conrad
- Connie Rose Cope
- Heidi E Cornhill
- Avonna Crabill
- Simon Peter Crass
All providers in Angola, IN · Intellectual and/or Developmental Disabilities Residential Treatment Facility in Indiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 22, 2020. 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.