Organization
MISERICORDIA HOME
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STEVE SCHUETH (CONTROLLER)
(773) 273-4191
Entity
Organization
Contact information
Practice address
6300 N RIDGE AVE, CHICAGO, IL 60660-1017
(773) 273-4191
Mailing address
6300 N RIDGE AVE, CHICAGO, IL 60660-1017
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
—
IL
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
199600013C
IL
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
2000594
IL
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
2000602
IL
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
2000644
IL
Other
Enumeration date
06/20/2016
Last updated
06/20/2016
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