Organization
ASI
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. REBECCA CRUZ MSW (EXECUTIVE DIRECTOR)
(773) 278-5130
Entity
Organization
Contact information
Practice address
2619 W. ARMITAGE AVE., CHICAGO, IL 60647-4208
(773) 278-5130
(773) 278-1380
Mailing address
2619 W. ARMITAGE AVE., CHICAGO, IL 60647-4208
(773) 278-5130
(773) 278-1380
Taxonomy
Speciality
Code
Description
License number
State
376J00000X
Homemaker
Primary
—
—
Other
Enumeration date
09/28/2012
Last updated
11/27/2012
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