Provider Demographics
NPI:1851324750
Name:COMMUNITY VENTURES IN LIVING, LTD.
Entity Type:Organization
Organization Name:COMMUNITY VENTURES IN LIVING, LTD.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:MIKE
Authorized Official - Middle Name:J
Authorized Official - Last Name:MORTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:765-449-0784
Mailing Address - Street 1:401 S EARL AVE
Mailing Address - Street 2:SUITE 2A
Mailing Address - City:LAFAYETTE
Mailing Address - State:IN
Mailing Address - Zip Code:47904-3606
Mailing Address - Country:US
Mailing Address - Phone:765-449-0784
Mailing Address - Fax:765-447-0912
Practice Address - Street 1:401 S EARL AVE
Practice Address - Street 2:SUITE 2A
Practice Address - City:LAFAYETTE
Practice Address - State:IN
Practice Address - Zip Code:47904-3606
Practice Address - Country:US
Practice Address - Phone:765-449-0784
Practice Address - Fax:765-447-0912
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN320900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities