Provider Demographics
NPI:1518045442
Name:COMMUNITY LINK, INC.
Entity Type:Organization
Organization Name:COMMUNITY LINK, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:A
Authorized Official - Last Name:HUELSKAMP
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:618-526-3905
Mailing Address - Street 1:1665 N 4TH ST
Mailing Address - Street 2:
Mailing Address - City:BREESE
Mailing Address - State:IL
Mailing Address - Zip Code:62230-1791
Mailing Address - Country:US
Mailing Address - Phone:618-526-8800
Mailing Address - Fax:618-526-2021
Practice Address - Street 1:1665 N 4TH ST
Practice Address - Street 2:
Practice Address - City:BREESE
Practice Address - State:IL
Practice Address - Zip Code:62230-1791
Practice Address - Country:US
Practice Address - Phone:618-526-8800
Practice Address - Fax:618-526-2021
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-01
Last Update Date:2015-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL251C00000X, 251E00000X, 320900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251C00000XAgenciesDay Training, Developmentally Disabled Services
No320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL01430355OtherBCBSIL
IL212358361OtherBEECH STREET
IL507910OtherHEALTHLINK
IL2019317OtherFIRST HEALTH
IL2019317OtherFIRST HEALTH