COMMUNITY LIVING SERVICES


Address: 21 N 11th St, Terre Haute, IN 47807-2743
Phone: 8124780724

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).

Provider Overview

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

Taxonomy

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 Provider/Organization Names

Other Name Type Code
Bridges of Indiana Doing Business As Name - Organization

Other Provider IDs and Locations

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

Other Data Sources

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

Office Location

Street Address 21 N 11TH ST
City TERRE HAUTE
State IN
Zip Code 47807-2743

Providers in the same zip code

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
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Taxonomy Information

Taxonomy Code 320900000X
Grouping Residential Treatment Facilities
Classification Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities

Taxonomy Definition

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]

Providers in the same taxonomy and city

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

Providers in the same taxonomy and state

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
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Competitor

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City TERRE HAUTE
Zip Code 47807

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Dataset Information

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.

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