Organization
ASSOCIATION HOUSE OF CHICAGO
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. HARRIET SADAUSKAS (PRESIDENT)
(773) 772-8009
Entity
Organization
Contact information
Practice address
2849 W WALTON ST, CHICAGO, IL 60622-4448
(773) 435-3205
(773) 395-7340
Mailing address
1116 N KEDZIE AVE, CHICAGO, IL 60651-4152
(773) 772-8009
(773) 292-5490
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
—
251C00000X
Developmentally Disabled Services Day Training Agency
—
IL
251S00000X
Community/Behavioral Health Agency
—
IL
302R00000X
Health Maintenance Organization
—
—
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
102
—
IL
01
—
IL5335
MEDICARE PTAN
IL
Enumeration date
06/21/2016
Last updated
06/21/2016
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