COMMUNITY LIVING OPTIONS INC (NPI# 1205008653) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1205008653 |
| Entity Type | Organization |
| Organization Name | COMMUNITY LIVING OPTIONS INC |
| Other Organization Name | FREEBURG TERRACE |
| Practice Address |
#4 Hill Mine Road Freeburg IL 62243-3225 |
| Mailing Address |
285 South Farnham Street Galesburg IL 61401-5323 |
| Practice Telephone | 6185394882 |
| Practice Fax Number | 6185394895 |
| Mailing Telephone | 3093431550 |
| Mailing Fax Number | 3093436318 |
| Enumeration Date | 2008-03-26 |
| Last Update Date | 2008-04-20 |
| Authorized Official Name | MR. RONALD J WILSON (AUTHORIZED AGENT) |
| Authorized Official Telephone | 3093431550 |
| Is Organization Subpart | Y |
| Parent Organization Name | COMMUNITY LIVING OPTIONS INC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 315P00000X | Intermediate Care Facility, Mentally Retarded | 36582 | IL | Nursing & Custodial Care Facilities |
| Other Name | Type Code |
|---|---|
| Freeburg Terrace | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639341563 | Community Living Options Inc | Intermediate Care Facility, Mentally Retarded | 321 Chestnut, Paris, IL 61944-1407 | 2008-04-01 |
| 1366614281 | Community Living Options Inc | Intermediate Care Facility, Mentally Retarded | 426 E Douglas, Jacksonville, IL 62650-2114 | 2008-04-01 |
| 1457523383 | Community Living Options Inc | Intermediate Care Facility, Mentally Retarded | 2883 Taylor Ave, Springfield, IL 62703-4323 | 2008-04-01 |
| 1447422373 | Community Living Options Inc | Intermediate Care Facility, Mentally Retarded | 408 Anna Street, Jacksonville, IL 62650-2847 | 2008-04-01 |
| 1720250640 | Community Living Options Inc | Intermediate Care Facility, Mentally Retarded | 2016 Windish Drive, Galesburg, IL 61401-9773 | 2008-04-01 |
| 1811169741 | Community Living Options Inc | Intermediate Care Facility, Mentally Retarded | 2182 Windish Drive, Galesburg, IL 61401-9775 | 2008-04-01 |
| 1902078835 | Community Living Options Inc | Intermediate Care Facility, Mentally Retarded | 356 S Michigan Ave, Galesburg, IL 61401-5443 | 2008-04-01 |
| 1710159645 | Community Living Options Inc | Intermediate Care Facility, Mentally Retarded | 1101 S Third Street, Effingham, IL 62401-4022 | 2008-04-01 |
| 1548432461 | Community Living Options Inc | Intermediate Care Facility, Mentally Retarded | 1450 Virginia Avenue, Wood River, IL 62095-1808 | 2008-04-01 |
| 1538331467 | Community Living Options Inc | Intermediate Care Facility, Mentally Retarded | 260 S Michigan Drive, Galesburg, IL 61401-5441 | 2008-04-01 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | COMMUNITY LIVING OPTIONS INC | 285 S Farnham St, Galesburg, IL 61401-5323 |
| Street Address |
#4 HILL MINE ROAD |
| City | FREEBURG |
| State | IL |
| Zip Code | 62243-3225 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225351703 | Apex Physical Therapy | Physical Therapist | 251 Marketplace Center, Freeburg, IL 62243 | 2010-03-11 |
| 1346308178 | Debra Ann Biekert | Speech-Language Pathologist | 934 Bay Pointe Dr, Freeburg, IL 62243 | 2006-12-05 |
| 1831289750 | Groceries of Southern Illinois, LLC | Pharmacy | 369 Marketplace Dr, Freeburg, IL 62243 | 2006-10-13 |
| 1255316725 | Vidya Deshpande | Pathology | 45 Sheffield Drive, Belleville, IL 62243 | 2005-12-07 |
| 1619537867 | Angela Kay Kern | Nurse Practitioner | 251 Marketplace Dr, Freeburg, IL 62243 | 2019-06-19 |
| 1386961464 | Jamie L Hahne | Massage Therapist | 102 N State St, Freeburg, IL 62243-1214 | 2010-04-28 |
| 1982600375 | Jannell W Vetter | Physical Therapist | 102 N State St, Freeburg, IL 62243-1246 | 2005-06-22 |
| 1902030927 | Matthew R. Leonard, S.c. | Chiropractor | 102 N State St, Suite A, Freeburg, IL 62243-1246 | 2009-05-05 |
| 1609995687 | Burl Wayne Hand IIi | Dentist | 201b W High St, Freeburg, IL 62243-1313 | 2007-03-28 |
| 1578727103 | Occupational Health Centers of Illinois PC | Clinic/Center | 501 W Apple St, Freeburg, IL 62243-1389 | 2008-07-13 |
| Find all providers in zip 62243 | ||||
| Taxonomy Code | 315P00000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Intermediate Care Facility, Mentally Retarded |
| (1) A public institution for care of the mentally retarded or people with related conditions. (2) An institution giving active treatment to mentally retarded or developmentally disabled persons or persons with related conditions. The primary purpose of the institution is to provide health or rehabilitative services to such individuals. |
| Notes: Sources: (1) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, IL: 1994, p. 403 (2) Paraphrased from Code of Federal Regulations #42, Public Health, Section 440.150(c). |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871039669 | Mount St Joseph | Intermediate Care Facility, Mentally Retarded | 24955 N Us Highway 12, Lake Zurich, IL 60047-8919 | 2017-01-17 |
| 1447792221 | Shore Community Services, Inc. | Intermediate Care Facility, Mentally Retarded | 8350 Laramie Ave, Skokie, IL 60077-2461 | 2016-11-10 |
| 1770930968 | Community Support Systems | Intermediate Care Facility, Mentally Retarded | 2311 Veterans Drive, Effingham, IL 62401 | 2016-05-18 |
| 1265898266 | Tdl Group, Inc. | Intermediate Care Facility, Mentally Retarded | 102 S Douglas St, Mc Leansboro, IL 62859-1637 | 2016-01-06 |
| 1164888160 | Tdl Group, Inc. | Intermediate Care Facility, Mentally Retarded | 1406 W Delaware St, Fairfield, IL 62837-2336 | 2016-01-06 |
| 1376909374 | Tdl Group, Inc | Intermediate Care Facility, Mentally Retarded | 416 Chula Vista Dr, Belleville, IL 62221-3160 | 2016-01-06 |
| 1437515434 | Tdl Group, Inc. | Intermediate Care Facility, Mentally Retarded | 206 N Washington St, Mc Leansboro, IL 62859-1049 | 2016-01-06 |
| 1790141885 | Tdl Group, Inc | Intermediate Care Facility, Mentally Retarded | 212 Turning Leaf Cir, Belleville, IL 62221-6747 | 2016-01-06 |
| 1790141794 | Tdl Group, Inc. | Intermediate Care Facility, Mentally Retarded | 867 County Road 2150 E, Fairfield, IL 62837-2824 | 2016-01-06 |
| 1255797254 | Tdl Group, Inc. | Intermediate Care Facility, Mentally Retarded | 9135 N Spring Garden Ln, Mount Vernon, IL 62864-6624 | 2016-01-06 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.