Organization · Type 2 NPI

Kirby Johnson

Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility · Chicago, IL

NPI number 1679966949 Active

Practice location

3807 N Leavitt St Apt 2
Chicago, IL 60618-3825

Specialties and licenses

Taxonomy	Code	License
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility Primary	320900000X	None listed

Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility: A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with intellectual and/or developmental disabilities.

2 other providers at this address

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About NPI 1679966949

Kirby Johnson's National Provider Identifier is 1679966949, issued on Mar 11, 2015. The primary taxonomy on file is Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility (320900000X), and the practice location is in Chicago, IL. The record was last updated on Mar 11, 2015.