Provider Demographics
NPI:1093993065
Name:ANNIE B. JONES COMMUNITY SERVICES, INC
Entity Type:Organization
Organization Name:ANNIE B. JONES COMMUNITY SERVICES, INC
Other - Org Name:ABJ COMMUNITY SERVICES, INC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:FOUNDER/PRESIDENT & CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:VIVIAN
Authorized Official - Middle Name:ROSE
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:MED
Authorized Official - Phone:773-667-2100
Mailing Address - Street 1:1507 E 53RD ST
Mailing Address - Street 2:PMB 336
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60615-4509
Mailing Address - Country:US
Mailing Address - Phone:773-667-2100
Mailing Address - Fax:773-667-6736
Practice Address - Street 1:1818 E 71ST ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60649-2010
Practice Address - Country:US
Practice Address - Phone:773-667-2100
Practice Address - Fax:773-667-9578
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-01
Last Update Date:2010-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ILA88350001A251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health