Organization
WARD HOUSE SUPPORTIVE SERVICES, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CYNTHIA WARD MPH (EXECUTIVE DIRECTOR)
(773) 846-1589
Entity
Organization
Contact information
Practice address
1049 W 87TH ST, CHICAGO, IL 60620-3328
(773) 846-1589
Mailing address
1049 W 87TH ST, CHICAGO, IL 60620-3328
(773) 846-1589
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MEDICAID PENDING
MEDICAID PENDING
IL
Enumeration date
12/31/2007
Last updated
12/31/2007
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