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CH05642AL LAWNDALE CHRISTIAN HEALTH CENTER (Terminated)
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Main Details
Name
LAWNDALE CHRISTIAN HEALTH CENTER
Subdivision Name
Temporary Site - West Lake
Type
HRSA-Funded Health Center
Site ID
BPS-H80-038201
340B ID
CH05642AL
Grant Number
H80CS00725
Additional Details
Current Program Status
Terminated
Registration Date
4/3/2024
Participating Start Date
7/1/2024
Participating Approval Date
5/20/2024
Last Recertification Date
Termination Date
Termination Reason
4/1/2025
Site closure
Contacts
Authorizing Official
Lawndale Christian Health Center
Christopher Robert Dons, Chief Financial Officer
(872) 588-3032
Primary Contact
Lawndale Christian Health Center
Alexandra Cueto, Internal Auditor
(872) 588-3027
Addresses
Street Address
939 W Lake St
Chicago, IL 60607-1719
Billing Address
Lawndale Christian Health Center
3860 W Ogden Avenue
Chicago, IL 60623
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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