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CH05642M LAWNDALE CHRISTIAN HEALTH CENTER (Terminated)
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Main Details
Name
LAWNDALE CHRISTIAN HEALTH CENTER
Subdivision Name
LCHC at Breaking Bread
Type
HRSA-Funded Health Center
Site ID
BPS-H80-015152
340B ID
CH05642M
Grant Number
H80CS00725
Additional Details
Current Program Status
Terminated
Registration Date
7/1/2016
Participating Start Date
10/1/2016
Participating Approval Date
7/29/2016
Last Recertification Date
2/6/2023
Termination Date
Termination Reason
1/1/2024
Other
Contacts
Authorizing Official
Lawndale Christian Health Center
Alyssa Sianghio, Chief Administrative Officer (CAO)
(872) 588-3015
Primary Contact
Lawndale Christian Health Center
Alexandra Cueto, Internal Auditor
(872) 588-3027
Addresses
Street Address
1111 N. Wells
Chicago, IL 60610
Billing Address
Lawndale Christian Health Center
3860 West Ogden Ave
Chicago, IL 60623
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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