Organization
SOUTH-EAST ASIA CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. FANNY WONG (EXECUTIVE DIRECTOR)
(773) 989-7433
Entity
Organization
Contact information
Practice address
5120 N BROADWAY ST, CHICAGO, IL 60640-3004
(773) 989-6927
(888) 831-5471
Mailing address
1134 W AINSLIE ST, CHICAGO, IL 60640-3602
(773) 989-7433
(888) 831-5471
Taxonomy
Speciality
Code
Description
License number
State
251V00000X
Voluntary or Charitable Agency
Primary
—
—
253Z00000X
In Home Supportive Care Agency
—
—
261QA0600X
Adult Day Care Clinic/Center
—
—
347C00000X
Private Vehicle
—
—
Other
Enumeration date
11/15/2012
Last updated
04/22/2017
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