Provider Demographics
NPI:1154776219
Name:COMMUNITY LIVING OPPORTUNITIES, INC
Entity type:Organization
Organization Name:COMMUNITY LIVING OPPORTUNITIES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ACCOUNTS RECEIVABLE
Authorized Official - Prefix:MRS
Authorized Official - First Name:KRISTEN
Authorized Official - Middle Name:
Authorized Official - Last Name:IVEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:913-341-9316
Mailing Address - Street 1:PO BOX 14395
Mailing Address - Street 2:
Mailing Address - City:LENEXA
Mailing Address - State:KS
Mailing Address - Zip Code:66285-4395
Mailing Address - Country:US
Mailing Address - Phone:913-341-9316
Mailing Address - Fax:913-341-1198
Practice Address - Street 1:7725 W 87TH ST
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66212-1905
Practice Address - Country:US
Practice Address - Phone:913-341-9316
Practice Address - Fax:913-341-1198
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:COMMUNITY LIVING OPPORTUNITIES, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-04-26
Last Update Date:2021-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
No261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Yes261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health