| Lydia Home Association | |
|
1101 Washington St Evanston IL 60202-1619 | |
| (847) 424-2450 | |
| Not Available |
| Full Name | Lydia Home Association |
|---|---|
| Speciality | Residential Treatment Facility, Emotionally Disturbed Children |
| Location | 1101 Washington St, Evanston, Illinois |
| Authorized Official Name and Position | Brian Clutter (DIRECTOR OF FINANCE) |
| Authorized Official Contact | 8476517195 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lydia Home Association 4300 W Irving Park Rd Chicago IL 60641-2825 Ph: (773) 736-1447 | Lydia Home Association 1101 Washington St Evanston IL 60202-1619 Ph: (847) 424-2450 |
| NPI Number | 1962123901 |
|---|---|
| Provider Enumeration Date | 09/08/2022 |
| Last Update Date | 09/08/2022 |
| Certification Date | 09/08/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962123901 | NPI | - | NPPES |
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