Organization · NPI-2

A New Age Human Services Corp.

Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities · Chicago, IL

NPI number1730623786
StatusActive
Last updated in NPPESDec 10, 2016

Details

NPI
1730623786
Entity type
Organization (NPI-2)
Legal business name
A New Age Human Services Corp.
Organization subpart
No
Enumeration date
Dec 10, 2016
Last updated
Dec 10, 2016

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities201500008CILYes

Other names

  • New Age Human Services (Doing Business As)

Practice location

5328 W Parker Ave
Chicago, IL 60639-1521

Phone 773-237-8793 · Fax 708-575-5903

Mailing address

5328 W Parker Ave
Chicago, IL 60639-1521

Phone 773-237-8793 · Fax 708-575-5903

Authorized official

Charissa Munoz-Ligo
Executive Director/Qidp/Rn
7734911480

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