Provider Demographics
NPI:1255735833
Name:REDEMPTA SERVICES NFP
Entity type:Organization
Organization Name:REDEMPTA SERVICES NFP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BOARD PRES
Authorized Official - Prefix:
Authorized Official - First Name:LOREN
Authorized Official - Middle Name:
Authorized Official - Last Name:PILGROM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:708-997-2262
Mailing Address - Street 1:PO BOX 553
Mailing Address - Street 2:
Mailing Address - City:RICHTON PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60471-0553
Mailing Address - Country:US
Mailing Address - Phone:708-624-0002
Mailing Address - Fax:
Practice Address - Street 1:23049 RICHTON SQUARE RD
Practice Address - Street 2:
Practice Address - City:RICHTON PARK
Practice Address - State:IL
Practice Address - Zip Code:60471-2618
Practice Address - Country:US
Practice Address - Phone:708-624-0002
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-10
Last Update Date:2016-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL201400010C320900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities