Provider Demographics
NPI:1205445285
Name:I AM ABLE CENTER FOR FAMILY DEVELOPMENT
Entity type:Organization
Organization Name:I AM ABLE CENTER FOR FAMILY DEVELOPMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:
Authorized Official - Last Name:LANG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:773-840-8062
Mailing Address - Street 1:3410 W ROOSEVELT RD
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60624-4343
Mailing Address - Country:US
Mailing Address - Phone:773-840-8062
Mailing Address - Fax:773-826-2966
Practice Address - Street 1:3410 W ROOSEVELT RD
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60624-4343
Practice Address - Country:US
Practice Address - Phone:773-840-8062
Practice Address - Fax:773-826-2966
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-27
Last Update Date:2020-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder