Provider Demographics
NPI:1639348253
Name:HUMAN RESOURCES DEVELOPMENT INSTITUTE, INC
Entity Type:Organization
Organization Name:HUMAN RESOURCES DEVELOPMENT INSTITUTE, INC
Other - Org Name:HRDI MENTAL HEALTH OUTPATIENT
Other - Org Type:Doing Business As
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 1:222 S JEFFERSON ST
Mailing Address - Street 2:200
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60661-5603
Mailing Address - Country:US
Mailing Address - Phone:312-441-9009
Mailing Address - Fax:312-441-9019
Practice Address - Street 1:33 E 114TH ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60628-4921
Practice Address - Country:US
Practice Address - Phone:773-660-4630
Practice Address - Fax:773-660-4650
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HUMAN RESOURCES DEVELOPMENT INSTITUTE, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-02-28
Last Update Date:2016-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL04073251B00000X
261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)