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Organization

RESIDENTIAL OPTIONS, INC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
SUSAN L STAFSTROM (ACCOUNTING MANAGER)
(618) 465-0044
Entity
Organization

Contact information

Practice address
1108 ENGINEER RD, GRANITE CITY, IL 62040-2890
(618) 797-2320
(618) 797-1745
Mailing address
1108 ENGINEER RD, GRANITE CITY, IL 62040-2890
(618) 797-2320
(618) 797-1745

Taxonomy

Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
0036210
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
6012546
PUBLIC HEALTH FACILITY ID
IL
Enumeration date
05/01/2007
Last updated
08/22/2020
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