Provider Demographics
NPI:1407292030
Name:HUMAN RESOURCES DEVELOPMENT INSTITUTE
Entity Type:Organization
Organization Name:HUMAN RESOURCES DEVELOPMENT INSTITUTE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF CONTRACT ADMINISTRATION
Authorized Official - Prefix:MS
Authorized Official - First Name:RENZY
Authorized Official - Middle Name:
Authorized Official - Last Name:RICHARDSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:312-441-9009
Mailing Address - Street 1:340 E 51ST ST
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60615-3509
Mailing Address - Country:US
Mailing Address - Phone:312-441-9009
Mailing Address - Fax:312-441-9019
Practice Address - Street 1:340 E 51ST ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60615-3509
Practice Address - Country:US
Practice Address - Phone:312-441-9009
Practice Address - Fax:312-441-9019
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-22
Last Update Date:2022-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL04073251S00000X
261QR0405X, 276400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder
No276400000XHospital UnitsRehabilitation, Substance Use Disorder Unit