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Organization

COMMUNITY LIVING, INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. RANDY THIEBAUT (PRESIDENT)
(260) 665-7681
Entity
Organization

Contact information

Practice address
413 W OAK ST, BUTLER, IN 46721-1337
(260) 665-7681
(260) 665-1501
Mailing address
PO BOX 6, ANGOLA, IN 46703-0006
(260) 665-7681
(260) 665-1501

Taxonomy

Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
2511I0002DE05
IN

Other

Enumeration date
06/03/2006
Last updated
08/22/2020
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