Provider Demographics
NPI:1164101176
Name:UNA OF THE USA
Entity Type:Organization
Organization Name:UNA OF THE USA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AMBASSADOR
Authorized Official - Prefix:
Authorized Official - First Name:CLINTON
Authorized Official - Middle Name:LAMONT
Authorized Official - Last Name:MONTGOMERY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:312-376-5827
Mailing Address - Street 1:5213 S SANGAMON ST
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60609-6141
Mailing Address - Country:US
Mailing Address - Phone:312-376-5827
Mailing Address - Fax:
Practice Address - Street 1:1750 PENNSYLVANIA AVE NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20006-4502
Practice Address - Country:US
Practice Address - Phone:312-376-5821
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-17
Last Update Date:2023-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Multi-Specialty