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RWII60623 Project Vida (Active)
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Main Details
Name
Project Vida
Subdivision Name
Type
Ryan White Part B
340B ID
RWII60623
Grant Number
X07HA00013
Additional Details
Current Program Status
Active
Registration Date
10/10/2019
Participating Start Date
1/1/2020
Participating Approval Date
12/9/2019
Last Recertification Date
2/14/2025
Time Period the Assistance was Received
4/1/2023 - 3/31/2026
Contacts
Authorizing Official
Project Vida Inc.
Jerome Montgomery, Executive Director
(773) 426-5997
Primary Contact
Project Vida Inc.
Alisa Montgomery-Williams, Board Chair
(773) 277-2291
Addresses
Street Address
2659 South Kedvale Ave
Chicago, IL 60623
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
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Participating from effective date: (1/1/2018), until terminated effective date: (04/01/2018); reinstatement effective date: (01/01/2020)
12/09/2019
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