OrganizationActive
Community Living, Inc
NPI 1720021512 · Intellectual and/or Developmental Disabilities Residential Treatment Facility · Angola, IN
Provider details
- NPI number
- 1720021512
- Entity type
- Organization
- Primary specialty
- Intellectual and/or Developmental Disabilities Residential Treatment FacilityResidential Treatment Facilities
- Organization subpart
- No
- Authorized official
- Randy Thiebaut, President(260) 665-7681
Specialties & taxonomies
Residential Treatment Facilities
Profile Score
Detailed profile(91/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
20 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
1102 W Mill St
Angola, IN 46703-1344
Phone: (260) 665-7681
Fax: (260) 665-1501
Street-level locationGet directions
Mailing address
Po Box 6
Angola, IN 46703-0006
Registry dates
- Enumerated
- 2006-06-13
- Last updated
- 2020-08-22
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.