Provider Demographics
NPI:1679309975
Name:GSGRACE CILA HOME LLC
Entity type:Organization
Organization Name:GSGRACE CILA HOME LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:
Authorized Official - Last Name:AINA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:773-627-0241
Mailing Address - Street 1:20635 ABBEY WOODS CT N STE 303
Mailing Address - Street 2:
Mailing Address - City:FRANKFORT
Mailing Address - State:IL
Mailing Address - Zip Code:60423-3191
Mailing Address - Country:US
Mailing Address - Phone:773-627-0241
Mailing Address - Fax:888-972-4225
Practice Address - Street 1:20635 ABBEY WOODS CT N STE 303
Practice Address - Street 2:
Practice Address - City:FRANKFORT
Practice Address - State:IL
Practice Address - Zip Code:60423-3191
Practice Address - Country:US
Practice Address - Phone:773-627-0241
Practice Address - Fax:888-972-4225
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-12
Last Update Date:2024-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities