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Organization
COMMUNITY LIVING OPTIONS INC
Active
Organization
COMMUNITY LIVING OPTIONS INC
Active
Parent organization
COMMUNITY LIVING OPTIONS INC
Other names
Wetherell Place
Organization subpart
Yes
Provider details
NPI number
Legal business name
COMMUNITY LIVING OPTIONS INC
Authorized official
MR. RONALD J WILSON (AUTHORIZED AGENT)
(309) 343-1550
Entity
Organization
Contact information
Practice address
1026 N MERCHANT STREET, EFFINGHAM, IL 62401-2125
(217) 342-6621
(217) 342-6687
Mailing address
285 SOUTH FARNHAM STREET, GALESBURG, IL 61401-5323
(309) 343-1550
(309) 343-6318
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
34074
IL
Other
Enumeration date
03/26/2008
Last updated
04/20/2008
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