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Organization
SHILOHS VILLAGE
Active
Organization
SHILOHS VILLAGE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JESSICA ANN GOODNIGHT (ADMINISTRATOR)
(773) 441-3718
Entity
Organization
Contact information
Practice address
6443 N DAMEN AVE APT 2W, CHICAGO, IL 60645-5610
(773) 441-3718
Mailing address
6443 N DAMEN AVE APT 2W, CHICAGO, IL 60645-5610
(773) 441-3718
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Enumeration date
10/22/2024
Last updated
10/22/2024
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