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
417 N ASH ST, BUTLER, IN 46721-1105
(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
2511I0005DE07
IN
Other
Enumeration date
06/07/2006
Last updated
08/22/2020
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