COMMUNITY LIVING OPTIONS INC (NPI# 1851563209) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1851563209 |
| Entity Type | Organization |
| Organization Name | COMMUNITY LIVING OPTIONS INC |
| Other Organization Name | BELLEFONTAINE PLACE |
| Practice Address |
98 Debra Lane Waterloo IL 62298-1479 |
| Mailing Address |
285 South Farnham Street Galesburg IL 61401-5323 |
| Practice Telephone | 6189393336 |
| Practice Fax Number | 6189396679 |
| 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 | 33993 | IL | Nursing & Custodial Care Facilities |
| Other Name | Type Code |
|---|---|
| Bellefontaine Place | 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 |
98 DEBRA LANE |
| City | WATERLOO |
| State | IL |
| Zip Code | 62298-1479 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508471418 | Waterloo Urgent Care Walk In Clinic Company | Clinic/Center | 901 Illinois Route 3, Waterloo, IL 62298 | 2020-09-09 |
| 1235624867 | Las Davis Enterprises | Hearing Instrument Specialist | 911 State Rte 3, Waterloo, IL 62298 | 2018-06-26 |
| 1255727269 | Anna Witges | Counselor | 988 Il-3, Waterloo, IL 62298 | 2015-04-07 |
| 1558766741 | Sheri Buettner | Counselor | 988 Illinois Route 3, Waterloo, IL 62298 | 2014-10-30 |
| 1386050953 | Jessica Liefer | Counselor | 988 N Illinois Rt 3, Waterloo, IL 62298 | 2014-07-03 |
| 1952729279 | Orthodontic Associates of Columbia and Waterloo | Dentist | 224 Bradford Lane Suite B, Waterloo, IL 62298 | 2014-04-03 |
| 1588963961 | Monroe County Surgical Center,llc | Clinic/Center | 501 Hamacher St, Waterloo, IL 62298 | 2011-03-24 |
| 1841523776 | Waterloo Women's Health | Nurse Practitioner | 869 N. Illinois Rt 3, Waterloo, IL 62298 | 2009-09-10 |
| 1548444011 | Marla Rae Smith | Nurse Practitioner | 869 North Illinois Rt 3, Waterloo, IL 62298 | 2007-12-20 |
| 1649464553 | Clarkson Optometry Illinois PC | Optometrist | 204 Bradford Lane, Waterloo, IL 62298 | 2007-09-04 |
| Find all providers in zip 62298 | ||||
| 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 |
|---|---|---|---|---|
| 1497819874 | Comprehensive Systems, Inc | Intermediate Care Facility, Mentally Retarded | 4049 Richland Dr, Waterloo, IA 50701-3118 | 2006-12-20 |
| 1477617264 | Comprehensive Systems, Inc | Intermediate Care Facility, Mentally Retarded | 2266 Country Ln, Waterloo, IA 50701-9736 | 2006-12-19 |
| 1396807038 | Comprehensive Systems, Inc. | Intermediate Care Facility, Mentally Retarded | 1100 S Hill Dr, Waterloo, IA 50701-5034 | 2006-12-15 |
| 1891267175 | Black Hawk Nursing and Rehabilitation, LLC | Intermediate Care Facility, Mentally Retarded | 1410 W Dunkerton Rd, Waterloo, IA 50703-9648 | 2018-12-26 |
| 1811067143 | Country View | Intermediate Care Facility, Mentally Retarded | 1410 W Dunkerton Rd, Waterloo, IA 50703-9648 | 2006-11-08 |
| 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.