Provider Demographics
NPI:1821245721
Name:COMMUNITY LIVING ARRANGEMENTS, INC.
Entity Type:Organization
Organization Name:COMMUNITY LIVING ARRANGEMENTS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:JOANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:ZUTZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:262-723-8392
Mailing Address - Street 1:PO BOX 200
Mailing Address - Street 2:
Mailing Address - City:ELKHORN
Mailing Address - State:WI
Mailing Address - Zip Code:53121-0200
Mailing Address - Country:US
Mailing Address - Phone:262-723-8392
Mailing Address - Fax:262-723-8379
Practice Address - Street 1:227 W JEFFERSON ST
Practice Address - Street 2:
Practice Address - City:ELKHORN
Practice Address - State:WI
Practice Address - Zip Code:53121-1211
Practice Address - Country:US
Practice Address - Phone:262-723-8392
Practice Address - Fax:262-723-8379
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-21
Last Update Date:2008-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI320600000X320600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities