ADA S. MCKINLEY COMMUNITY SERVICES INC. NPI 1871845008

NPI Information

NPI: 1871845008
Provider Name: ADA S. MCKINLEY COMMUNITY SERVICES, INC.

Doing Business As: MOORE HOUSE

Classification: Intermediate Care Facility, Intellectual Disabilities - 315P00000X
Entity Type: Organization
Address:
9135 SOUTH BRANDON
CHICAGO, IL
ZIP 60617
Phone: (773) 731-4033
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ADA S. MCKINLEY COMMUNITY SERVICES, INC. is an intermediate care facility mentally retarded in Chicago, IL. The provider is an intermediate care facility providing services for individuals with intellectual disabilities. ADA S. MCKINLEY COMMUNITY SERVICES, INC. NPI is 1871845008. The provider is registered as an organization entity type.
The provider Is Doing Business As Moore House.

The provider's business location address is:

9135 SOUTH BRANDON
CHICAGO, IL
ZIP 60617-420
Phone: (773) 731-4033
Fax: (773) 731-2376

The provider's authorized official is Donna Ree .
The authorized official title is Director Of Quality Assurance and has the following contact phone number (312) 385-2031.

The enumeration date for this NPI number is 10/11/2012 and was last updated on 7/21/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	320600000X	Residential Treatment Facility, Intellectual and/or Developmental Disabilities		0005	ILLINOIS	No
2	315P00000X	Intermediate Care Facility, Intellectual Disabilities				Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	0030593	OTHER	ILLINOIS	IDPH LICENSE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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