ACCESS COMMUNITY EXPERIENCE, INC.


Address: 4530 S Woodlawn Ave Unit 104, Chicago, IL 60653-4487
Phone: 7082713463

ACCESS COMMUNITY EXPERIENCE, INC. (NPI# 1912353962) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1912353962
Entity Type Organization
Organization Name ACCESS COMMUNITY EXPERIENCE, INC.
Practice Address 4530 S Woodlawn Ave Unit 104
Chicago
IL 60653-4487
Practice Telephone 7082713463
Practice Fax Number 7739665437
Mailing Telephone 7082713463
Mailing Fax Number 7739665437
Enumeration Date 2016-05-09
Last Update Date 2016-05-09
Authorized Official Name MR. MELAKU TADESSE (CEO)
Authorized Official Telephone 7082713463
Authorized Official Credential QIDP
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 320900000X Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities 201500011C IL Residential Treatment Facilities

Office Location

Street Address 4530 S WOODLAWN AVE UNIT 104
City CHICAGO
State IL
Zip Code 60653-4487

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Taxonomy Information

Taxonomy Code 320900000X
Grouping Residential Treatment Facilities
Classification Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities

Taxonomy Definition

A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with mental retardation and/or developmental disabilities.
Notes: [7/1/2003: new]

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1730623786 A New Age Human Services Corp. Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities 5328 W Parker Ave, Chicago, IL 60639-1521 2016-12-10
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City CHICAGO
Zip Code 60653

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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