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Organization
OTTAWA FRIENDSHIP HOUSE WORK ACTIVITY CENTER, INC
Active
Organization
OTTAWA FRIENDSHIP HOUSE WORK ACTIVITY CENTER, INC
Active
Other names
Sullivan House
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. BETH ANN MANGOLD (EXECUTIVE DIRECTOR)
(815) 434-0737
Entity
Organization
Contact information
Practice address
600 GROVER AVE, OTTAWA, IL 61350-4140
(815) 433-5858
Mailing address
1718 N 2525TH RD, OTTAWA, IL 61350-9329
(815) 434-0737
(815) 434-0493
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
14G117
—
IL
Enumeration date
10/31/2014
Last updated
10/31/2014
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