Organization
ADA S. MCKINLEY COMMUNITY SERVICES, INC.
Active
Other names
DAVIS HOUSE
Organization subpart
No
Provider details
NPI number
Authorized official
KEN FRIES (DIR QA&C)
(630) 744-9431
Entity
Organization
Contact information
Practice address
4237 S INDIANA AVE, CHICAGO, IL 60653-3213
(773) 373-1044
(773) 373-2387
Mailing address
1359 W WASHINGTON BLVD, CHICAGO, IL 60607-1905
(312) 385-2000
(312) 554-0292
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
—
—
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0030585
IDPH LICENSE
IL
Enumeration date
10/11/2012
Last updated
05/06/2025
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