Healthcare Provider Details

I. General information

NPI: 1306030556
Provider Name (Legal Business Name): URHAI COMMUNITY SERVICE CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/30/2007
Last Update Date: 06/21/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2945 W PETERSON AVE
CHICAGO IL
60659-3811
US

IV. Provider business mailing address

2945 W PETERSON AVE
CHICAGO IL
60659-3811
US

V. Phone/Fax

Practice location:
  • Phone: 773-275-2688
  • Fax: 773-275-2599
Mailing address:
  • Phone: 773-275-2688
  • Fax: 773-275-2599

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number State

VIII. Authorized Official

Name: MISS ANGEL KINDO
Title or Position: EXECUTIVE DIRECTOR
Credential: N/A
Phone: 773-275-2688