OrganizationActive
Residential Options, Inc.
NPI 1104047174 · Intellectual Disabilities Intermediate Care Facility · Alton, IL
Provider details
- NPI number
- 1104047174
- Entity type
- Organization
- Primary specialty
- Intellectual Disabilities Intermediate Care FacilityNursing & Custodial Care Facilities
- Organization subpart
- No
- Authorized official
- Diane Tebbe, Vp(618) 465-0044
- License
- 0039123 (IL)
Specialties & taxonomies
Nursing & Custodial Care Facilities
- Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility320900000XLicense 0039123 (IL)
Residential Treatment Facilities
Profile Score
Detailed profile(89/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
19 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
4617 Wonderland Dr
Alton, IL 62002-7309
Phone: (618) 465-8845
Fax: (618) 463-4890
Approximate (ZIP-level) locationGet directions
Mailing address
4617 Wonderland Dr
Alton, IL 62002-7309
Registry dates
- Enumerated
- 2007-05-01
- Last updated
- 2022-07-21
- Certified
- 2022-07-21
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.