Provider Demographics
NPI:1699296129
Name:LOREN 'HALF' ROBINSON FOUNDATION
Entity type:Organization
Organization Name:LOREN 'HALF' ROBINSON FOUNDATION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO/DIRECTOR OF BOARD OF DIRECTORS
Authorized Official - Prefix:
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:J
Authorized Official - Last Name:SEARCY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:773-521-1601
Mailing Address - Street 1:4100 W OGDEN AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60623-2821
Mailing Address - Country:US
Mailing Address - Phone:773-521-1601
Mailing Address - Fax:
Practice Address - Street 1:4100 W OGDEN AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60623-2821
Practice Address - Country:US
Practice Address - Phone:773-521-1601
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-07-06
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ILA85450001A261QM2800X, 261QR0405X
261QM2800X, 261QR0405X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2800XAmbulatory Health Care FacilitiesClinic/CenterMethadone
No261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder