OrganizationActive
Community Living Options Inc
NPI 1164694501 · Intellectual Disabilities Intermediate Care Facility · Wood River, IL
Provider details
- NPI number
- 1164694501
- Entity type
- Organization
- Primary specialty
- Intellectual Disabilities Intermediate Care FacilityNursing & Custodial Care Facilities
- Parent organization
- Community Living Options Inc
- Organization subpart
- Yes
- Authorized official
- Ronald Wilson, Authorized Agent(309) 343-1550
- License
- 39703 (IL)
Specialties & taxonomies
Nursing & Custodial Care Facilities
Profile Score
Detailed profile(87/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
18 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
460 Pershing
Wood River, IL 62095-1316
Phone: (618) 258-1616
Fax: (618) 258-1641
Street-level locationGet directions
Mailing address
285 South Farnham Street
Galesburg, IL 61401-5323
Other names (DBA / former)
- Doing business as
- Pershing Terrace
Registry dates
- Enumerated
- 2008-03-26
- Last updated
- 2008-04-20
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.