COMMUNITY LIVING OPTIONS INC (NPI# 1952573305) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1952573305 |
| Entity Type | Organization |
| Organization Name | COMMUNITY LIVING OPTIONS INC |
| Other Organization Name | TAYLOR HOUSE |
| Practice Address |
3021 Taylor Avenue Springfield IL 62703-5568 |
| Mailing Address |
285 South Farnham Street Galesburg IL 61401-5323 |
| Practice Telephone | 2175292186 |
| Practice Fax Number | 2175291880 |
| 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 | 35030 | IL | Nursing & Custodial Care Facilities |
| Other Name | Type Code |
|---|---|
| Taylor House | 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 |
3021 TAYLOR AVENUE |
| City | SPRINGFIELD |
| State | IL |
| Zip Code | 62703-5568 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790260917 | Jessica Lynne Zeeck | Behavior Technician | 5220 6th Street Frontage Road, E Suite 1700, Springfield, IL 62703 | 2018-10-03 |
| 1215415799 | Bree Schmulbach | Nurse Practitioner | Bsb Room 20, Springfield, IL 62703 | 2018-08-06 |
| 1144712100 | Fresenius Medical Care Springfield East, LLC | Clinic/Center | 140 S. Martin Luther King Jr. Drive, Springfield, IL 62703 | 2018-06-05 |
| 1558889170 | Ji Woung Choi | Dentist | 687 E Linton Ave., Springfield, IL 62703 | 2017-09-04 |
| 1477006161 | Encompass Home Health of The Midwest,llc | Home Health | 2970 Baker Dr, Springfield, IL 62703 | 2016-07-28 |
| 1851706824 | Terah Louise Holland | Obstetrics & Gynecology | 1100 E Lincolnshire Blvd Ste 200, Springfield, IL 62703 | 2014-06-27 |
| 1578993101 | Corey Moore | Behavioral Analyst | 5520 South 6th Street Road, Suite 1700, Springfield, IL 62703 | 2013-11-18 |
| 1134463052 | The Center for Youth and Family Solutions Inc. | Voluntary or Charitable | 614 North Sixth Street, Springfield, IL 62703 | 2012-11-15 |
| 1447519111 | Tenshi Furumi | Specialist/Technologist | One University Plaza, Univ. of Illinois-springfield, Ms Rec 2004, Springfield, IL 62703 | 2012-05-15 |
| 1447558390 | Shalini Mulkanoor | Family Medicine | 1100 E. Lincolnshire Blvd., Suite 200, Springfield, IL 62703 | 2011-03-02 |
| Find all providers in zip 62703 | ||||
| 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 |
|---|---|---|---|---|
| 1275039315 | Consumer Support Services, Inc. | Intermediate Care Facility, Mentally Retarded | 3154 El Camino Dr, Springfield, OH 45503-1318 | 2018-04-05 |
| 1124407309 | Communities of Don Guanella and Divine Providence | Intermediate Care Facility, Mentally Retarded | 1745 S. Sproul Rd, Springfield, PA 19064 | 2015-05-21 |
| 1477932655 | Communities of Don Guanella and Divine Providence | Intermediate Care Facility, Mentally Retarded | 1755 S. Sproul Rd, Springfield, PA 19064 | 2015-05-21 |
| 1003295288 | Communities of Don Guanella and Divine Providence | Intermediate Care Facility, Mentally Retarded | 1765 S. Sproul Rd, Springfield, PA 19064 | 2015-05-21 |
| 1811306038 | Communities of Don Guanella and Divine Providence | Intermediate Care Facility, Mentally Retarded | 813 W Rolling Rd, Springfield, PA 19064-1122 | 2014-08-13 |
| 1689927592 | Community Residences, Inc. | Intermediate Care Facility, Mentally Retarded | 8714 Parliament Dr, Springfield, VA 22151-1225 | 2012-10-17 |
| 1457523383 | Community Living Options Inc | Intermediate Care Facility, Mentally Retarded | 2883 Taylor Ave, Springfield, IL 62703-4323 | 2008-04-01 |
| 1306018437 | Community Living Options Inc | Intermediate Care Facility, Mentally Retarded | 3310 Gaines Mill Rd, Springfield, IL 62704-5709 | 2008-03-28 |
| 1356513790 | Community Living Options Inc | Intermediate Care Facility, Mentally Retarded | 2724 Glenwood Ave, Springfield, IL 62704-5010 | 2008-03-26 |
| 1699981076 | Rescare Inc | Intermediate Care Facility, Mentally Retarded | 305 W Hillcrest Dr, Springfield, TN 37172-3841 | 2007-05-15 |
| Find all providers in SPRINGFIELD | ||||
| City | SPRINGFIELD |
| Zip Code | 62703 |
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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.