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Organization
RESIDENTIAL OPTIONS, INC.
Active
Organization
RESIDENTIAL OPTIONS, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DIANE TEBBE (VP)
(618) 465-0044
Entity
Organization
Contact information
Practice address
4710 PIERCE LN, GODFREY, IL 62035-4151
(618) 466-5255
(618) 466-7450
Mailing address
4710 PIERCE LN, GODFREY, IL 62035-4151
(618) 466-5255
(618) 466-7450
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
—
—
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
0036814
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6012744
PUBLIC HEALTH FACILITY ID
IL
Enumeration date
04/25/2007
Last updated
11/01/2017
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