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Organization
PARK LAWN HOME
Active
Organization
PARK LAWN HOME
Active
Parent organization
PARK LAWN SCHOOL & ACTIVITY CENTER, INC.
Organization subpart
Yes
Provider details
NPI number
Legal business name
PARK LAWN SCHOOL & ACTIVITY CENTER, INC.
Authorized official
JAMES R. WEISE (EXECUTIVE DIRECTOR)
(708) 425-3344
Entity
Organization
Contact information
Practice address
10833 LAPORTE AVE, OAK LAWN, IL 60453-5412
(708) 425-3344
(708) 425-3530
Mailing address
12615 S KOSTNER AVE, ALSIP, IL 60803-2625
(708) 385-1982
(708) 385-8145
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
0035527
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0035527
—
IL
Enumeration date
09/27/2010
Last updated
09/27/2010
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