Organization
ACCESS COMMUNITY EXPERIENCE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MELAKU TADESSE QIDP (CEO)
(708) 271-3463
Entity
Organization
Contact information
Practice address
4530 S WOODLAWN AVE UNIT 104, CHICAGO, IL 60653-4487
(708) 271-3463
(773) 966-5437
Mailing address
4530 S WOODLAWN AVE UNIT 104, CHICAGO, IL 60653-4487
(708) 271-3463
(773) 966-5437
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
201500011C
IL
Other
Enumeration date
05/09/2016
Last updated
05/09/2016
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