Provider Demographics
NPI:1639346265
Name:COMMUNITY OPTIONS & RESOURCES
Entity Type:Organization
Organization Name:COMMUNITY OPTIONS & RESOURCES
Other - Org Name:COR I
Other - Org Type:Other Name
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:PENNY
Authorized Official - Middle Name:L
Authorized Official - Last Name:CLAUSSEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:507-728-8444
Mailing Address - Street 1:104 MILL STREET
Mailing Address - Street 2:
Mailing Address - City:WELCOME
Mailing Address - State:MN
Mailing Address - Zip Code:56181-5045
Mailing Address - Country:US
Mailing Address - Phone:507-728-8444
Mailing Address - Fax:507-728-8360
Practice Address - Street 1:104 MILL ST
Practice Address - Street 2:
Practice Address - City:WELCOME
Practice Address - State:MN
Practice Address - Zip Code:56181-5045
Practice Address - Country:US
Practice Address - Phone:507-728-8444
Practice Address - Fax:507-728-8360
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-13
Last Update Date:2008-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN800864315P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes315P00000XNursing & Custodial Care FacilitiesIntermediate Care Facility, Intellectual Disabilities