Organization
URBAN LODGE SUPPORTIVE LIVING
Active
Other names
Urban Lodge Supportive Living LLC
Organization subpart
No
Provider details
NPI number
Authorized official
IESHA SHANAE HAIRSTON LPN (OWNER)
(708) 735-1123
Entity
Organization
Contact information
Practice address
762 PULASKI RD, CALUMET CITY, IL 60409-4018
(708) 735-1123
Mailing address
762 PULASKI RD, CALUMET CITY, IL 60409-4018
(708) 735-1123
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Enumeration date
11/20/2025
Last updated
11/20/2025
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