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Organization

OUR CHILDRENS HOMESTEAD

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. ROBERT G GENIESSE (CHIEF EXECUTIVE OFFICER)
(630) 369-0004
Entity
Organization

Contact information

Practice address
387 SHUMAN BLVD, SUITE 335W, NAPERVILLE, IL 60563-8450
(630) 369-0004
(630) 369-0085
Mailing address
387 SHUMAN BLVD, SUITE 335W, NAPERVILLE, IL 60563-8450
(630) 369-0004
(630) 369-0085

Taxonomy

Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
266994
IL

Other

Enumeration date
05/24/2006
Last updated
08/22/2020
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