| Pilsen Little Village Community Mental Health Center, Inc. | |
|
1546 N Mannheim Rd Stone Park IL 60165-1117 | |
| (708) 410-0856 | |
| Not Available |
| Full Name | Pilsen Little Village Community Mental Health Center, Inc. |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 1546 N Mannheim Rd, Stone Park, Illinois |
| Authorized Official Name and Position | Francisco Cisneros (PRESIDENT & CEO) |
| Authorized Official Contact | 7735790832 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Pilsen Little Village Community Mental Health Center, Inc. 2319 S Damen Ave Chicago IL 60608-4209 Ph: (773) 579-0832 | Pilsen Little Village Community Mental Health Center, Inc. 1546 N Mannheim Rd Stone Park IL 60165-1117 Ph: (708) 410-0856 |
| NPI Number | 1457942047 |
|---|---|
| Provider Enumeration Date | 01/27/2021 |
| Last Update Date | 08/27/2021 |
| Certification Date | 08/26/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457942047 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |