NINE FORTY CULLOM CORPORATION
Intermediate Care Facility, Mental Illness
Chicago, Illinois
Provider NPI: 1912998188
Organization Information:Organization Name: NINE FORTY CULLOM CORPORATION
Practice Location:
940 W CULLOM AVE CHICAGO, IL 60613 US
Tel: 773-525-9000 Fax: --
Business Mailing Address:
,
Tel: -- Fax: --
Taxonomy:
Practice Location:
940 W CULLOM AVE CHICAGO, IL 60613 US
Tel: 773-525-9000 Fax: --
Business Mailing Address:
,
Tel: -- Fax: --
Taxonomy:
Primary | Code | Category/Description | State | License Number |
---|---|---|---|---|
Y | 310500000X | Nursing & Custodial Care Facilities Intermediate Care Facility, Mental Illness | IL | 0017178 |