Organization
ACTIVE VISIONS, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DENISE BAAS (ASSISTANT EXECUTIVE DIRECTOR)
(773) 594-0921
Entity
Organization
Contact information
Practice address
5408 W DEVON AVE, CHICAGO, IL 60646-4106
(773) 594-0921
(773) 594-1238
Mailing address
5408 W DEVON AVE, CHICAGO, IL 60646-4106
(773) 594-0921
(773) 594-1238
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
199700004C
IL
Other
Enumeration date
09/28/2015
Last updated
09/28/2015
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