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General NPI Number Information
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NPI Number | 1124076419
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Entity Type | Organization
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Legal Business Name | ASSOCIATION HOUSE OF CHICAGO
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Dates
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Enumeration Date | 05/05/2006
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Last Update Date | 11/10/2016
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Provider Practice Location Address
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Address Line | 1116 N. KEDZIE AVENUE
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City | CHICAGO
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State | IL
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Zip | 60651
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Country | US
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Telephone | 773-772-8004
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Fax | 773-772-1752
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Provider Business Mailing Address
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Address Line | 1116 N. KEDZIE AVENUE
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City | CHICAGO
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State | IL
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Zip | 60651
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Country | US
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Telephone | 773-772-8004
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Fax | 773-772-1752
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Authorized Official
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Title or Position | PRESIDENT
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Name | MS. HARRIET SADAUSKAS
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Credential |
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Telephone | 773-772-7170
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251K00000X
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Taxonomy Name | Public Health or Welfare Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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