| Sertoma Centre, Inc. | |
|
4343 W 123rd St Alsip IL 60803-1807 | |
| (708) 739-6216 | |
| (708) 371-9700 |
| Full Name | Sertoma Centre, Inc. |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 4343 W 123rd St, Alsip, Illinois |
| Authorized Official Name and Position | Gus Van Den Brink (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 7087306216 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Sertoma Centre, Inc. 4343 W 123rd St Alsip IL 60803-1807 Ph: (708) 739-6216 | Sertoma Centre, Inc. 4343 W 123rd St Alsip IL 60803-1807 Ph: (708) 739-6216 |
| NPI Number | 1982201414 |
|---|---|
| Provider Enumeration Date | 10/07/2020 |
| Last Update Date | 10/07/2020 |
| Certification Date | 10/01/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1982201414 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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