Organization
A NEW AGE HUMAN SERVICES CORP.
Active
Other names
New Age Human Services
Organization subpart
No
Provider details
NPI number
Authorized official
CHARISSA MUNOZ-LIGO (EXECUTIVE DIRECTOR/QIDP/RN)
(773) 491-1480
Entity
Organization
Contact information
Practice address
5328 W PARKER AVE, CHICAGO, IL 60639-1521
(773) 237-8793
(708) 575-5903
Mailing address
5328 W PARKER AVE, CHICAGO, IL 60639-1521
(773) 237-8793
(708) 575-5903
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
201500008C
IL
Other
Enumeration date
12/10/2016
Last updated
12/10/2016
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