Provider Demographics
NPI:1215654595
Name:OPTIONS IN COMMUNITY LIVING INC.
Entity type:Organization
Organization Name:OPTIONS IN COMMUNITY LIVING INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ACCOUNTING & FINANCE ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:LUKE
Authorized Official - Middle Name:
Authorized Official - Last Name:WOLFGRAM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:608-249-1585
Mailing Address - Street 1:551 GRAND OAK TRL
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53714-9106
Mailing Address - Country:US
Mailing Address - Phone:608-249-1585
Mailing Address - Fax:608-249-3372
Practice Address - Street 1:551 GRAND OAK TRL
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53714-9106
Practice Address - Country:US
Practice Address - Phone:608-249-1585
Practice Address - Fax:608-249-3372
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-26
Last Update Date:2022-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care