institution
Divine Center, Inc
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Chicago, Illinois
NPI 1831545268

Divine Center, Inc is a Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility based in Chicago, IL. Divine Center, Inc practices in Chicago, IL. The NPI Number for Divine Center, Inc is 1831545268 and holds a License No. 200400002C (Illinois).

The current practice location address for Divine Center, Inc is 8351 S Marquette Ave, Chicago, IL and can be reached out via phone at 773-721-6535 and via fax at 773-721-7065.

Location: 8351 S Marquette Ave, Chicago, IL, 60617-2022
institution
Provider Profile Details
NPI Number
1831545268
Provider Name
Divine Center, Inc
Credential
Provider Entity Type
Organization
Address
8351 S Marquette Ave, Chicago, IL, 60617-2022
Phone Number
773-721-6535
Fax Number
773-721-7065
Provider Enumeration Date
05/04/2016
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
3000006 01 IL DHS DDD
7094638 01 IL DHS DDD
institution
Provider Business Practice Location Address Details
Address
8351 S Marquette Ave
City
State
Zip
60617-2022
Phone Number
773-721-6535
Fax Number
773-721-7065
person
Provider Business Mailing Address Details
Address
8351 S Marquette Ave
City
State
Zip
60617-2022
Phone Number
773-721-6535
Fax Number
773-721-7065
person
Provider's Taxonomy Details 1
Type
Residential Treatment Facilities
Classification
Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Speciality
-
Taxonomy
License No.
200400002C (Illinois)
Definition
A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with intellectual and/or developmental disabilities.
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