St. Mary Of Providence Developmental Training Program

LBN: St. Mary Of Providence Developmental Training Program
St. Mary Of Providence Developmental Training Program is an health care organization with primary practice located at 4200 N Austin Ave , Chicago IL 60634-1615. The organization recently has only one registered license in Agencies / Day Training, Developmentally Disabled Services, which is considered as the primary health care specialty. St. Mary Of Providence Developmental Training Program can be contacted via phone (773) 545-8300, or through Badiola, Charleen M via phone (773) 545-8300.

Contact Information

Primary practice address
4200 N Austin Ave Chicago IL 60634-1615
Phone: (773) 545-8300
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Badiola, Charleen M
Phone: (773) 545-8300

Health care specialties

SpecialtyCodeLicense #State
Agencies / Day Training, Developmentally Disabled Services 251C00000X 36217748 Illinois

Profile Details

NPI number 1609224328
LBN Legal business name St. Mary Of Providence Developmental Training Program
DBA Doing business as
Authorized official Badiola, Charleen M
Entity Organization
Organization subpart 1 Yes
Enumeration date Jun 3rd, 2016
Last updated Jun 3rd, 2016 - about 9 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1609224328 NPPES
Illinois MEDICAID 14G191

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