COMMUNITY LIVING, INC (NPI# 1477882371) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1477882371 |
Entity Type | Organization |
Organization Name | COMMUNITY LIVING, INC |
Practice Address |
429 N Superior St Angola IN 46703-1442 |
Mailing Address |
Po Box 6 Angola IN 46703-0006 |
Practice Telephone | 2606657681 |
Mailing Telephone | 2606657681 |
Enumeration Date | 2009-12-24 |
Last Update Date | 2009-12-24 |
Authorized Official Name | MR. RANDY THIEBAUT (PRESIDENT) |
Authorized Official Telephone | 2606657681 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 320600000X | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 2511I0007DE04 | IN | Residential Treatment Facilities |
State | Issuer | Identifier | Type Code |
---|---|---|---|
IN | 100235290 | 05 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1316980774 | Community Living, Inc | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 2000 W 175 N, Angola, IN 46703-7117 | 2006-06-14 |
1720021512 | Community Living, Inc | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1102 W Mill St, Angola, IN 46703-1344 | 2006-06-13 |
1578506093 | Community Living, Inc | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 512 W Green St, Butler, IN 46721-1073 | 2006-06-13 |
1346280765 | Community Living, Inc | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 417 N Ash St, Butler, IN 46721-1105 | 2006-06-07 |
1295773109 | Community Living, Inc | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 413 W Oak St, Butler, IN 46721-1337 | 2006-06-03 |
1568409845 | Community Living, Inc | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 433 N Superior St, Angola, IN 46703-1442 | 2006-06-02 |
1912197559 | Community Living, Inc | Day Training, Developmentally Disabled Services | 314 E Atlantic St, South Hill, VA 23970-2006 | 2007-07-30 |
Entity Type | Entity Name | Entity Address |
---|---|---|
Massachusetts Corporations | COMMUNITY LIVING, INC. | 11 Upton St, Boston, MA 02118 |
Street Address |
429 N SUPERIOR ST |
City | ANGOLA |
State | IN |
Zip Code | 46703-1442 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1629617097 | Carolyn Yvonne Davis | Registered Nurse | 909b South Darling Street, Angola, IN 46703 | 2020-01-02 |
1588144760 | Travis William Simmons | Chiropractor | 1220 N 200 W, Angola, IN 46703 | 2018-08-17 |
1386025427 | Jessica Conrad | Physical Therapist | 1913 North Wayne St, Suite D, Angola, IN 46703 | 2015-06-15 |
1578977385 | Amber Joy Richards | Counselor | 200 Hoosier Dr. Suite E, Angola, IN 46703 | 2014-06-19 |
1972874667 | Amanda Louise Traxler | Specialist/Technologist | 350 S John Mcbride Ave, Angola, IN 46703 | 2012-01-26 |
1659656155 | Kelly Balyeat | Pharmacist | 2012 North Wayne Street, Angola, IN 46703 | 2011-10-15 |
1689843930 | Erin Nicole Culler | Pharmacist | 2290 North Wayne Street, Angola, IN 46703 | 2008-02-20 |
1235319963 | J Andrew Stoner | Counselor | 430 N Wayne St, Suite 201, Angola, IN 46703 | 2007-11-09 |
1760537658 | Margaret Jean Schreiber | Nurse Practitioner | 103 Intertech Parkway, Suite A, Angola, IN 46703 | 2007-01-24 |
1922163120 | Tamara Lynn Watkins | Dentist | 101 N. Terrace Blvd., Angola, IN 46703 | 2006-12-27 |
Find all providers in zip 46703 |
Taxonomy Code | 320600000X |
Grouping | Residential Treatment Facilities |
Classification | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities |
A residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with developmental disabilities and/or mental retardation and are not able to live independently. |
Notes: [7/1/2003: new] |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1720021512 | Community Living, Inc | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1102 W Mill St, Angola, IN 46703-1344 | 2006-06-13 |
1568409845 | Community Living, Inc | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 433 N Superior St, Angola, IN 46703-1442 | 2006-06-02 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1861999450 | Pathfinder Services Inc | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 4438 Haney Ct, New Haven, IN 46774-1777 | 2018-04-10 |
1548796089 | Branches Residential Services | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 13096 Glenside Dr, Fishers, IN 46037-8863 | 2017-05-03 |
1346691177 | Miami Homecare Services, LLC | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1912 Miami St, South Bend, IN 46613-2915 | 2016-06-22 |
1033418066 | Bona Vista Programs, Inc. | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 3770 W 80 N, Kokomo, IN 46901-3854 | 2011-03-16 |
1124327150 | Bona Vista Programs, Inc. | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 112 Westmoreland Dr E, Kokomo, IN 46901-5104 | 2011-03-16 |
1366745010 | Adec Inc | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 3302 N. Main St, Michawaka, IN 46545-3148 | 2010-12-17 |
1457670044 | P L Ford Homes/indiana | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 519 E 60th Ave, Merrillville, IN 46410-3068 | 2010-05-22 |
1043533177 | Peak Community Services Inc. | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1234 S 50 E, Winamac, IN 46996-8590 | 2010-03-03 |
1154644276 | Peak Community Services, Inc. | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1141 19th St, Logansport, IN 46947-4507 | 2010-03-03 |
1316260441 | Peak Community Services Inc. | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1625 High St, Logansport, IN 46947-2863 | 2010-03-03 |
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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.