Provider Demographics
NPI:1225161953
Name:COMMUNITY OPTIONS
Entity Type:Organization
Organization Name:COMMUNITY OPTIONS
Other - Org Name:COMMUNITY OPTIONS OF CHILLICOTHE; CONCERNED CITIZENS FOR THE
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:JOYCE
Authorized Official - Middle Name:ELAINE
Authorized Official - Last Name:JACOBS
Authorized Official - Suffix:
Authorized Official - Credentials:QMRP
Authorized Official - Phone:660-646-0109
Mailing Address - Street 1:801 WASHINGTON ST # B
Mailing Address - Street 2:
Mailing Address - City:CHILLICOTHE
Mailing Address - State:MO
Mailing Address - Zip Code:64601-2231
Mailing Address - Country:US
Mailing Address - Phone:660-646-0109
Mailing Address - Fax:660-646-2808
Practice Address - Street 1:801 WASHINGTON ST # B
Practice Address - Street 2:
Practice Address - City:CHILLICOTHE
Practice Address - State:MO
Practice Address - Zip Code:64601-2231
Practice Address - Country:US
Practice Address - Phone:660-646-0109
Practice Address - Fax:660-646-2808
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-13
Last Update Date:2019-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
No251C00000XAgenciesDay Training, Developmentally Disabled Services
No385H00000XRespite Care FacilityRespite Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO853019305Medicaid