Provider Demographics
NPI:1689703811
Name:COMMUNITY LIVING & LEARNING, INC
Entity Type:Organization
Organization Name:COMMUNITY LIVING & LEARNING, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:LAURETTA
Authorized Official - Middle Name:L
Authorized Official - Last Name:LUTZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:724-349-1420
Mailing Address - Street 1:1430 ROUTE 286 HWY E
Mailing Address - Street 2:SUITE 2
Mailing Address - City:INDIANA
Mailing Address - State:PA
Mailing Address - Zip Code:15701-1459
Mailing Address - Country:US
Mailing Address - Phone:724-349-1420
Mailing Address - Fax:724-349-6552
Practice Address - Street 1:1430 ROUTE 286 HWY E
Practice Address - Street 2:SUITE 2
Practice Address - City:INDIANA
Practice Address - State:PA
Practice Address - Zip Code:15701-1459
Practice Address - Country:US
Practice Address - Phone:724-349-1420
Practice Address - Fax:724-349-6552
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-05
Last Update Date:2007-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA414900251C00000X
PA461500320900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
No251C00000XAgenciesDay Training, Developmentally Disabled Services