Provider Demographics
NPI:1548656788
Name:RESIDENTIAL OPTIONS, INC.
Entity type:Organization
Organization Name:RESIDENTIAL OPTIONS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DIANE
Authorized Official - Middle Name:
Authorized Official - Last Name:TEBBE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:618-465-0044
Mailing Address - Street 1:4 EMMIE L KAUS LN
Mailing Address - Street 2:
Mailing Address - City:ALTON
Mailing Address - State:IL
Mailing Address - Zip Code:62002-8865
Mailing Address - Country:US
Mailing Address - Phone:618-465-0044
Mailing Address - Fax:618-462-4124
Practice Address - Street 1:750 S MORELAND RD
Practice Address - Street 2:LOT # 31
Practice Address - City:BETHALTO
Practice Address - State:IL
Practice Address - Zip Code:62010-2172
Practice Address - Country:US
Practice Address - Phone:618-462-0751
Practice Address - Fax:618-463-1678
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-14
Last Update Date:2015-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL199400229S320900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities