Organization
DOMINION CILA HOMES INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. PATRICIA OMOROGBE (EXECUTIVE DIRECTOR)
(708) 418-1608
Entity
Organization
Contact information
Practice address
3043 RIDGE RD STE 201, LANSING, IL 60438-3080
(708) 418-1608
Mailing address
3043 RIDGE RD STE 201, LANSING, IL 60438-3080
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
201300011C
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
44CSA03053
—
IL
Enumeration date
10/16/2013
Last updated
10/16/2013
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