Provider Demographics
NPI:1790710010
Name:THE CHILDREN'S PLACE HOME HEALTH ASSOCIATION
Entity Type:Organization
Organization Name:THE CHILDREN'S PLACE HOME HEALTH ASSOCIATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT & CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:CATHY
Authorized Official - Middle Name:
Authorized Official - Last Name:KRIEGER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:312-660-3021
Mailing Address - Street 1:3059 W. AUGUSTA
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60622
Mailing Address - Country:US
Mailing Address - Phone:773-826-1230
Mailing Address - Fax:773-826-0705
Practice Address - Street 1:3059 W. AUGUSTA
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60622
Practice Address - Country:US
Practice Address - Phone:773-826-1230
Practice Address - Fax:773-826-0705
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:THE CHILDREN'S PLACE ASSOCIATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-07-12
Last Update Date:2013-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1009372163WP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WP0200XNursing Service ProvidersRegistered NursePediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL1009372OtherHOME HEALTH AGENCY SKILLED NURSING MEDICAL SOCIAL SERVICES