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CH05642R LAWNDALE CHRISTIAN HEALTH CENTER (Terminated)
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Main Details
Name
LAWNDALE CHRISTIAN HEALTH CENTER
Subdivision Name
LCHC at San Jose Obrero
Type
HRSA-Funded Health Center
Site ID
BPS-H80-020827
340B ID
CH05642R
Grant Number
H80CS00725
Additional Details
Current Program Status
Terminated
Registration Date
1/14/2019
Participating Start Date
4/1/2019
Participating Approval Date
1/15/2019
Last Recertification Date
1/28/2020
Termination Date
Termination Reason
4/1/2021
Site closure
Contacts
Authorizing Official
Lawndale Christian Health Center
Alyssa Sianghio, Chief Administrative Officer (CAO)
(872) 588-3015
Primary Contact
Lawndale Christian Health Center
Christopher Robert Dons, Chief Financial Officer
(872) 588-3032
Addresses
Street Address
1856 S Loomis St
Chicago, IL 60623-3019
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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