Organization · NPI-2

Ada S. Mckinley Community Services, INC.

Intermediate Care Facility, Intellectual Disabilities · Chicago, IL

NPI number1871845008
StatusActive
Last updated in NPPESMay 6, 2025

Details

NPI
1871845008
Entity type
Organization (NPI-2)
Legal business name
Ada S. Mckinley Community Services, INC.
Organization subpart
No
Enumeration date
Oct 11, 2012
Certification date
May 6, 2025
Last updated
May 6, 2025

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
315P00000X Intermediate Care Facility, Intellectual Disabilities––Yes
320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities0005IL

Other names

  • Moore House (Doing Business As)

Practice location

9135 South Brandon
Chicago, IL 60617-4420

Phone 773-731-4033 · Fax 773-731-2376

Mailing address

1359 W Washington Blvd
Chicago, IL 60607-1905

Phone 312-385-2000 · Fax 312-554-0292

Authorized official

Ken Fries
Dir Qa&C
3123852022

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