NPIMap

Organization Active NPI

Residential Options, Inc.

  • Intellectual Disabilities Intermediate Care Facility
  • Godfrey, IL
National Provider Identifier
1770702763
Registry record updated Nov 1, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual Disabilities Intermediate Care FacilityTaxonomy code 315P00000X
Legal business name
RESIDENTIAL OPTIONS, INC.
Practice address
4710 Pierce LN
Godfrey, IL 62035-4151
Phone
(618) 466-5255
Fax
(618) 466-7450
NPI assigned
Apr 25, 2007
Last updated
Nov 1, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 1, 2017

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

Authorized official

Name
Diane Tebbe
Title
VP
Phone
(618) 465-0044

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual Disabilities Intermediate Care Facility 315P00000X NU Primary
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility 320900000X 0036814 IL

Addresses

Primary practice location

4710 Pierce LN
Godfrey, IL 62035-4151

Mailing address

4710 Pierce LN
Godfrey, IL 62035-4151
Phone (618) 466-5255

Other identifiers 1

IdentifierTypeStateIssuer
6012744OtherILPUBLIC 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

Locations

4710 Pierce Ln
Godfrey, IL 62035
Phone (618) 466-5255

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": "1509494400000",
    "number": "1770702763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4710 PIERCE LN",
            "city": "GODFREY",
            "state": "IL",
            "postal_code": "620354151",
            "telephone_number": "618-466-5255",
            "fax_number": "618-466-7450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4710 PIERCE LN",
            "city": "GODFREY",
            "state": "IL",
            "postal_code": "620354151",
            "telephone_number": "618-466-5255",
            "fax_number": "618-466-7450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RESIDENTIAL OPTIONS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-25",
        "last_updated": "2017-11-01",
        "status": "A",
        "authorized_official_last_name": "TEBBE",
        "authorized_official_first_name": "DIANE",
        "authorized_official_title_or_position": "VP",
        "authorized_official_telephone_number": "618-465-0044"
    },
    "taxonomies": [
        {
            "code": "315P00000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Intellectual Disabilities",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "IL",
            "license": "0036814",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PUBLIC HEALTH FACILITY ID",
            "identifier": "6012744",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Godfrey, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2017; 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.