Organization
OHANA COMMUNITY SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALBERTO A ROSARIO (CEO/PRESIDENT)
(773) 313-6646
Entity
Organization
Contact information
Practice address
4931 W THOMAS ST, CHICAGO, IL 60651-3129
(773) 313-6646
Mailing address
4931 W THOMAS ST, CHICAGO, IL 60651-3129
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
201800006C
IL
Other
Enumeration date
05/07/2018
Last updated
05/07/2018
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