Provider Demographics
NPI:1669689337
Name:COMMUNITY LIVING ALLIANCE, INC.
Entity type:Organization
Organization Name:COMMUNITY LIVING ALLIANCE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COMPLIANCE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:MATTHEW
Authorized Official - Last Name:LOWNDES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:6080-242-8335
Mailing Address - Street 1:1414 MAC ARTHUR RD
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53714-1318
Mailing Address - Country:US
Mailing Address - Phone:608-242-8335
Mailing Address - Fax:608-240-7060
Practice Address - Street 1:1414 MAC ARTHUR RD
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53714-1318
Practice Address - Country:US
Practice Address - Phone:608-242-8335
Practice Address - Fax:608-240-7060
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management