Provider Demographics
NPI:1215387519
Name:LITTLE ANGELS ECE
Entity Type:Organization
Organization Name:LITTLE ANGELS ECE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:S.
Authorized Official - Middle Name:V
Authorized Official - Last Name:KATSIBAROS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:773-478-5555
Mailing Address - Street 1:3613 W DEVON AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60659-1207
Mailing Address - Country:US
Mailing Address - Phone:773-478-5555
Mailing Address - Fax:888-745-3166
Practice Address - Street 1:3613 W DEVON AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60659-1207
Practice Address - Country:US
Practice Address - Phone:773-478-5555
Practice Address - Fax:888-745-3166
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-16
Last Update Date:2016-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services