Provider Demographics
NPI:1689058588
Name:P.A.C.T.T. LEARNING CENTER
Entity Type:Organization
Organization Name:P.A.C.T.T. LEARNING CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:KRISTEN
Authorized Official - Middle Name:
Authorized Official - Last Name:HUFFMAN - GOTTSCHLING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:773-338-9102
Mailing Address - Street 1:7101 N GREENVIEW AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60626-2628
Mailing Address - Country:US
Mailing Address - Phone:773-338-9102
Mailing Address - Fax:773-338-9103
Practice Address - Street 1:7101 N GREENVIEW AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60626-2628
Practice Address - Country:US
Practice Address - Phone:773-338-9102
Practice Address - Fax:773-338-9103
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-10
Last Update Date:2015-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251S00000X
IL320600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities
No251S00000XAgenciesCommunity/Behavioral Health