Healthcare Provider Details

I. General information

NPI: 1710187851
Provider Name (Legal Business Name): COMMUNITY OPTIONS, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/18/2007
Last Update Date: 07/18/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

801 S FILLMORE ST
AMARILLO TX
79101-3537
US

IV. Provider business mailing address

16 FARBER RD
PRINCETON NJ
08540-5913
US

V. Phone/Fax

Practice location:
  • Phone: 806-379-6901
  • Fax: 806-379-6875
Mailing address:
  • Phone: 609-951-9900
  • Fax: 609-779-8960

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code385HR2060X
TaxonomyChild Intellectual and/or Developmental Disabilities Respite Care
License Number
License Number StateTX
# 3
Primary TaxonomyY
Taxonomy Code320900000X
TaxonomyIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
License Number
License Number StateTX

VIII. Authorized Official

Name: MR. ROBERT STACK
Title or Position: PRESIDENT & C.E.O.
Credential: B.S., M.A.
Phone: 609-951-9900