Provider Demographics
NPI:1396149985
Name:COMMUNITY OPTIONS, INC.
Entity type:Organization
Organization Name:COMMUNITY OPTIONS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO & PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:P
Authorized Official - Last Name:STACK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:609-951-9900
Mailing Address - Street 1:16 FARBER RD
Mailing Address - Street 2:
Mailing Address - City:PRINCETON
Mailing Address - State:NJ
Mailing Address - Zip Code:08540-5913
Mailing Address - Country:US
Mailing Address - Phone:609-951-9900
Mailing Address - Fax:609-951-9112
Practice Address - Street 1:5751 UPTAIN RD
Practice Address - Street 2:SUITE 407
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37411-4010
Practice Address - Country:US
Practice Address - Phone:423-892-0022
Practice Address - Fax:423-892-7910
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-10
Last Update Date:2014-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNL000000012772320600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN00677OtherDEPARTMENT OF INTELLECTUAL & DEVELOPMENTAL DISABILITIES