Organization
COMMUNITY LINK, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHN A HUELSKAMP (EXECUTIVE DIRECTOR)
(618) 526-3905
Entity
Organization
Contact information
Practice address
1665 N 4TH ST, BREESE, IL 62230-1791
(618) 526-8800
(618) 526-2021
Mailing address
1665 N 4TH ST, BREESE, IL 62230-1791
(618) 526-8800
(618) 526-2021
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
—
IL
251E00000X
Home Health Agency
Primary
—
IL
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01430355
BCBSIL
IL
01
—
2019317
FIRST HEALTH
IL
01
—
212358361
BEECH STREET
IL
01
—
507910
HEALTHLINK
IL
Enumeration date
11/01/2006
Last updated
12/01/2015
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