Provider Demographics
NPI:1932365798
Name:HTHA FAMILY SERVICE MINISTRIES
Entity Type:Organization
Organization Name:HTHA FAMILY SERVICE MINISTRIES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT,CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:CLARA
Authorized Official - Middle Name:IFEOMA
Authorized Official - Last Name:NNADI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:773-955-4777
Mailing Address - Street 1:2011 E 75TH ST STE 112
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60649-3646
Mailing Address - Country:US
Mailing Address - Phone:773-955-4777
Mailing Address - Fax:
Practice Address - Street 1:2011 E 75TH ST STE 112
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60649-3646
Practice Address - Country:US
Practice Address - Phone:773-955-4777
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-31
Last Update Date:2008-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL251S00000X251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health