Provider Demographics
NPI:1790293744
Name:FIRST ZION HOMES
Entity Type:Organization
Organization Name:FIRST ZION HOMES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:BASIRAT
Authorized Official - Middle Name:OMOLARA
Authorized Official - Last Name:OYEBIYI
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:773-610-8108
Mailing Address - Street 1:2601 SURF CT
Mailing Address - Street 2:
Mailing Address - City:LYNWOOD
Mailing Address - State:IL
Mailing Address - Zip Code:60411-1447
Mailing Address - Country:US
Mailing Address - Phone:773-610-8108
Mailing Address - Fax:
Practice Address - Street 1:2601 SURF CT
Practice Address - Street 2:
Practice Address - City:LYNWOOD
Practice Address - State:IL
Practice Address - Zip Code:60411-1447
Practice Address - Country:US
Practice Address - Phone:773-610-8108
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-11
Last Update Date:2018-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL201800001C320900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities