COMMUNITY LIVING SERVICES (NPI# 1619054350) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619054350 |
| Entity Type | Organization |
| Organization Name | COMMUNITY LIVING SERVICES |
| Other Organization Name | BRIDGES OF INDIANA |
| Practice Address |
21 N 11th St Terre Haute IN 47807-2743 |
| Practice Telephone | 8124780724 |
| Practice Fax Number | 8122358037 |
| Mailing Telephone | 8124780724 |
| Mailing Fax Number | 8122358037 |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MRS. PRISCILLA SUSUANNE BURLISON (DIRECTOR OF FINANCE) |
| Authorized Official Telephone | 8124780724 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 320900000X | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | IN | Residential Treatment Facilities |
| Other Name | Type Code |
|---|---|
| Bridges of Indiana | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306115365 | Community Living Services | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 8517 Airline Ave, Urbandale, IA 50322-2317 | 2011-12-21 |
| 1568545655 | Community Living Services | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1304 Ivy St, Waynesboro, VA 22980-2625 | 2006-10-23 |
| 1043685621 | Community Living Services | Point of Service | 1262 Wyoming Ave, Exeter, PA 18643-1454 | 2015-12-08 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Virginia Business Entities | COMMUNITY LIVING SERVICES INC. | 139 Mica Road, Ridgeway, Virginia 24148 |
| System for Award Management (SAM) Entities | COMMUNITY LIVING SERVICES OF SEDGWICK COUNTY | 1100 E Wyatt Earp Blvd, Dodge City, KS 67801-5337 |
| System for Award Management (SAM) Entities | COMMUNITY LIVING SERVICES, INC. | 35425 W Michigan Ave, Wayne, MI 48184-1687 |
| Street Address |
21 N 11TH ST |
| City | TERRE HAUTE |
| State | IN |
| Zip Code | 47807-2743 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972150175 | Acceleraed Rehabilitation Centers Ltd | Physical Therapist | 516 Wabash Ave, Terre Haute, IN 47807 | 2019-08-22 |
| 1548753403 | Terre Haute Aal Lp | Assisted Living Facility | 650 Lafayette Avenue, Terre Haute, IN 47807 | 2018-06-14 |
| 1790286300 | Hamilton Center, Inc. | Clinic/Center | 88 Court Wabash Court, Terre Haute, IN 47807 | 2018-02-28 |
| 1073022703 | Charles Martinez | Case Manager/Care Coordinator | 1619 5th Ave, Terre Haute, IN 47807 | 2017-09-26 |
| 1326578931 | Ian Nicholas Bostock | Specialist/Technologist | 1113 North 8th Street, Terre Haute, IN 47807 | 2017-06-15 |
| 1619309804 | Kimberly R Rollings | Audiologist | 1429 North Sixth Street, Terre Haute, IN 47807 | 2013-07-30 |
| 1376827550 | Lazaro Vu | Pharmacist | 1300 Wabash Avenue, Terre Haute, IN 47807 | 2011-10-05 |
| 1609016211 | Midwest Neurosurgery, P.C. | Specialist | 1530 N. 7th Street, Suite 106, Terre Haute, IN 47807 | 2009-02-23 |
| 1114007838 | Micheal J Deady Dds Inc | Oral & Maxillofacial Surgery | 1630 Poplar St, Terre Haute, IN 47807 | 2006-10-17 |
| 1316958549 | Wabash Valley Urological Assoc Inc | Specialist | 1235 Ohio Street, Terre Haute, IN 47807 | 2006-08-11 |
| Find all providers in zip 47807 | ||||
| Taxonomy Code | 320900000X |
| Grouping | Residential Treatment Facilities |
| Classification | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities |
| A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with mental retardation and/or developmental disabilities. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043596109 | Community Connections, Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 2222 Lafayette Ave, Terre Haute, IN 47805-2916 | 2011-11-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336749910 | Aspire Residential Services, LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 11216 Harrington Ln, Fishers, IN 46038-3208 | 2020-10-31 |
| 1366041121 | Latresa Renee Sims | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1777 Armstrong St. Suite C., Portage, IN 46368 | 2020-10-22 |
| 1619528700 | A Totality of Care | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 4302 Parrish Ave, East Chicago, IN 46312-3031 | 2019-09-20 |
| 1750851192 | Stimuli Residential Services | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 6670 Kinnerton Dr, Indianapolis, IN 46254-5843 | 2018-11-28 |
| 1659847168 | Assured Residential and Consulting, LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 5555 N Tacoma Ave Ste 101, Indianapolis, IN 46220-3551 | 2018-10-23 |
| 1427560002 | Swan Garden Home Services LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 4906 Quail Ridge Ln, Indianapolis, IN 46254 | 2017-11-03 |
| 1477063923 | Gray Residential Services, LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 9660 Commerce Dr, Carmel, IN 46032-7641 | 2017-10-10 |
| 1700248564 | A.i.d. Residential Services, LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 10319 Dawsons Creek Blvd Ste E, Fort Wayne, IN 46825-1911 | 2016-03-22 |
| 1518338664 | First Steps | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 57358 Sequoia Dr, Goshen, IN 46528-8829 | 2015-10-15 |
| 1497144042 | Jennifer Whitlow | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 6710 Waverhill Dr, Indianapolis, IN 46217-9101 | 2015-01-21 |
| Find all providers with the same taxonomy | ||||
| City | TERRE HAUTE |
| Zip Code | 47807 |
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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.