MEDICARE: COMMUNITY LEADERSHIP FOR CHILDREN AND FAMILIES NFP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	343900000X	Non-emergency Medical Transport (VAN)

General Provider Information

NPI Number	:	1467827642
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COMMUNITY LEADERSHIP FOR CHILDREN AND FAMILIES NFP

Provider Business Mailing Address
First Line	:	13246 S LANGLEY AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60827-1336
Country	:	US
Telephone Number	:	312-730-3618
Fax Number	:

Provider Business Practice Location Address
First Line	:	13246 S LANGLEY AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60827-1336
Country	:	US
Telephone Number	:	312-730-3618
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	NONI ARNOLD
Credential	:	NEMT
Telephone Number	:	312-730-3618

Provider Enumeration Date	:	12/14/2015
Last Update Date	:	12/14/2015

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