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General NPI Number Information
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NPI Number | 1891045241
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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 | 09/13/2012
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Last Update Date | 06/20/2018
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Provider Practice Location Address
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Address Line | 1900 NORTH SAWYER 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 | 773-772-7170
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Fax |
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Provider Business Mailing Address
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Address Line | 1116 NORTH KEDZIE AVE
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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 | 773-772-7170
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MRS. 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 | 322D00000X
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Taxonomy Name | Emotionally Disturbed Childrens' Residential Treatment Facility
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License Number | 02805111
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License Number State | IL
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