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General NPI Number Information
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NPI Number | 1205445285
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Entity Type | Organization
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Legal Business Name | I AM ABLE CENTER FOR FAMILY DEVELOPMENT
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Dates
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Enumeration Date | 07/27/2020
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Last Update Date | 07/27/2020
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Provider Practice Location Address
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Address Line | 3410 W ROOSEVELT RD
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City | CHICAGO
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State | IL
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Zip | 60624-4343
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Country | US
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Telephone | 773-840-8062
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Fax | 773-826-2966
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Provider Business Mailing Address
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Address Line | 3410 W ROOSEVELT RD
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City | CHICAGO
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State | IL
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Zip | 60624-4343
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Country | US
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Telephone | 773-840-8062
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Fax | 773-826-2966
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Authorized Official
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Title or Position | BUSINESS MANAGER
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Name | DEBORAH LANG
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Credential |
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Telephone | 773-840-8062
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0405X
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Taxonomy Name | Substance Use Disorder Rehabilitation Clinic/Center
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License Number |
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License Number State |
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