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CH05642F LAWNDALE CHRISTIAN HEALTH CENTER (Terminated)
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Main Details
Name
LAWNDALE CHRISTIAN HEALTH CENTER
Subdivision Name
LCHC at Bobby E. Wright
Type
HRSA-Funded Health Center
Site ID
BPS-H80-015256
340B ID
CH05642F
Grant Number
H80CS00725
Additional Details
Current Program Status
Terminated
Registration Date
7/1/2016
Participating Start Date
10/1/2016
Participating Approval Date
7/6/2016
Last Recertification Date
2/6/2023
Termination Date
Termination Reason
1/1/2024
Site closure
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
9 Kedzie Ave
Chicago, IL 60612
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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