OrganizationActive
A New Age Human Services Corp.
NPI 1730623786 · Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility · Chicago, IL
Provider details
- NPI number
- 1730623786
- Entity type
- Organization
- Primary specialty
- Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityResidential Treatment Facilities
- Authorized official
- Charissa Munoz-Ligo, Executive Director/Qidp/Rn
- License
- 201500008C (IL)
Practice location
5328 W Parker Ave
Chicago, IL 60639-1521
Phone: (773) 237-8793
Fax: (708) 575-5903
Mailing address
5328 W Parker Ave
Chicago, IL 60639-1521
Registry dates
- Enumerated
- 2016-12-10
- Last updated
- 2016-12-10
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.