Provider Demographics
NPI:1336582279
Name:JANASTON MANAGEMENT & DEVELOPMENT CORPORATION
Entity Type:Organization
Organization Name:JANASTON MANAGEMENT & DEVELOPMENT CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO, COUNSELOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:RENEE
Authorized Official - Last Name:WESLEY-JOSEPH
Authorized Official - Suffix:
Authorized Official - Credentials:CADC, GERONTOLOGIST
Authorized Official - Phone:773-261-0075
Mailing Address - Street 1:4942 W DIVISION
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60651
Mailing Address - Country:US
Mailing Address - Phone:773-261-0075
Mailing Address - Fax:
Practice Address - Street 1:4942 W DIVISION ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60651-3158
Practice Address - Country:US
Practice Address - Phone:773-261-0075
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-10
Last Update Date:2013-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
No251C00000XAgenciesDay Training, Developmentally Disabled Services