Organization
HONEYSUCKLE HOME INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CRYSTAL TRINIDAD NP (DON/ PROGRAM ADMINISTRATOR/ OWNER)
(773) 512-6193
Entity
Organization
Contact information
Practice address
4017 W OGDEN AVE, CHICAGO, IL 60623-2820
(773) 512-6193
Mailing address
4017 W OGDEN AVE, CHICAGO, IL 60623-2820
(773) 512-6193
Taxonomy
Speciality
Code
Description
License number
State
320700000X
Physical Disabilities Residential Treatment Facility
Primary
—
—
Other
Enumeration date
06/04/2025
Last updated
06/04/2025
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