A New Age Human Services Corp.
Organization Active NPI Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility · Chicago, IL
NPI 1730623786 · NPPES record last updated Dec 10, 2016
Key facts
- NPI
- 1730623786
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility 320900000X
- License
- 201500008C (IL)
- Legal business name
- A NEW AGE HUMAN SERVICES CORP.
- Practice address
- 5328 W Parker Ave
Chicago, IL 60639-1521 - Phone
- (773) 237-8793
- Fax
- (708) 575-5903
- NPI assigned
- Dec 10, 2016
- Organization subpart
- No
Authorized official
- Name
- Charissa Munoz-Ligo
- Title
- Executive Director/Qidp/RN
- Phone
- (773) 491-1480
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility | 320900000X | 201500008C | IL | Yes |
Addresses
Primary practice location
5328 W Parker Ave
Chicago, IL 60639-1521
Mailing address
5328 W Parker Ave
Chicago, IL 60639-1521
Phone (773) 237-8793
Other names
- New Age Human Services
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 10, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.