# COMMUNITY LIVING, INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1720021512
- **Authorized official:** MR. RANDY THIEBAUT (PRESIDENT)
- **Authorized official phone:** (260) 665-7681

## Contact information

- **Practice address:** 1102 W MILL ST, ANGOLA, IN 46703-1344
- **Practice address phone:** (260) 665-7681
- **Practice address fax:** (260) 665-1501
- **Mailing address:** PO BOX 6, ANGOLA, IN 46703-0006
- **Mailing address phone:** (260) 665-7681
- **Mailing address fax:** (260) 665-1501

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 320600000X | Intellectual and/or Developmental Disabilities Residential Treatment Facility | — | IN | Yes |

## Other

- **Enumeration date:** 06/13/2006
- **Last updated:** 08/22/2020