| Southwest Community Services, Inc. | |
|
58 W 162nd St South Holland IL 60473-2061 | |
| (708) 825-1986 | |
| Not Available |
| Full Name | Southwest Community Services, Inc. |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 58 W 162nd St, South Holland, Illinois |
| Authorized Official Name and Position | Mary Pat Ambrosino (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 7084291260 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Southwest Community Services, Inc. 6775 Prosperi Dr Tinley Park IL 60477-4789 Ph: (708) 429-1260 | Southwest Community Services, Inc. 58 W 162nd St South Holland IL 60473-2061 Ph: (708) 825-1986 |
| NPI Number | 1730432733 |
|---|---|
| Provider Enumeration Date | 10/16/2012 |
| Last Update Date | 10/16/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730432733 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | 04128 (Illinois) | Primary |
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