Community Living Options INC
Intermediate Care Facility, Intellectual Disabilities in Effingham, IL. Organization (NPI-2).
NPI number1508038951
StatusActive
Last updated in NPPESApr 20, 2008
Details
- NPI
- 1508038951
- Entity type
- Organization (NPI-2)
- Legal business name
- Community Living Options INC
- Organization subpart
- Yes
- Enumeration date
- Mar 26, 2008
- Last updated
- Apr 20, 2008
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 315P00000X | Intermediate Care Facility, Intellectual Disabilities | 34074 | IL | Yes |
Other names
- Wetherell Place (Doing Business As)
Practice location
1026 N Merchant StreetEffingham, IL 62401-2125
Phone 217-342-6621 · Fax 217-342-6687
Mailing address
285 South Farnham StreetGalesburg, IL 61401-5323
Phone 309-343-1550 · Fax 309-343-6318
Authorized official
Ronald J Wilson
Authorized Agent
3093431550
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