Organization
N HYACINTH HOME LLC
Active
Other names
Hyacinth Home
Organization subpart
No
Provider details
NPI number
Authorized official
SHERANN IVY APN (CEO)
(312) 468-9075
Entity
Organization
Contact information
Practice address
2418 W JACKSON BLVD, CHICAGO, IL 60612-2938
(312) 468-9075
(864) 383-6062
Mailing address
2418 W JACKSON BLVD, CHICAGO, IL 60612-2938
(312) 468-9075
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
—
—
Other
Enumeration date
07/02/2024
Last updated
07/02/2024
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