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
4617 WONDERLAND DR, ALTON, IL 62002-7309
(618) 465-8845
(618) 463-4890
Mailing address
4617 WONDERLAND DR, ALTON, IL 62002-7309
(618) 465-8845
(618) 463-4890
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
0039123
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6013973
PUBLIC HEALTH FACILITY ID
IL
Enumeration date
05/01/2007
Last updated
07/21/2022
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