Organization
RESIDENTIAL OPTIONS, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DIANE TEBBE (VICE PRESIDENT)
(618) 465-0044
Entity
Organization
Contact information
Practice address
1282 RIDGEWOOD CT, COLLINSVILLE, IL 62234-4146
(618) 346-1360
(618) 346-1363
Mailing address
4 EMMIE L KAUS LN, ALTON, IL 62002-8865
(618) 465-0044
(618) 462-4124
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
94S229
IL
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
94S229
IL
Other
Enumeration date
06/02/2009
Last updated
06/02/2009
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