Provider Demographics
NPI:1427236751
Name:HUMAN RESOURCES DEVELOPMENT INSTITUTE, INC
Entity type:Organization
Organization Name:HUMAN RESOURCES DEVELOPMENT INSTITUTE, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF CONTRACT ADMINISTRATION
Authorized Official - Prefix:MS
Authorized Official - First Name:RENZY
Authorized Official - Middle Name:
Authorized Official - Last Name:RICHARDSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:312-441-9009
Mailing Address - Street 1:222 S JEFFERSON ST
Mailing Address - Street 2:200
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60661-5603
Mailing Address - Country:US
Mailing Address - Phone:312-441-9009
Mailing Address - Fax:312-441-9019
Practice Address - Street 1:8000 S RACINE AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60620-3011
Practice Address - Country:US
Practice Address - Phone:773-994-2708
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HUMAN RESOURCES DEVELOPMENT INSTITUTE, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-02-08
Last Update Date:2020-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL261QM2800X
261QR0405X, 276400000X
IL001800013251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No261QM2800XAmbulatory Health Care FacilitiesClinic/CenterMethadone
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder
No276400000XHospital UnitsRehabilitation, Substance Use Disorder Unit