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Organization
PILSEN-LITTLE VILLAGE COMMUNITY MENTAL HEALTH CENTER, INC
Active
Organization
PILSEN-LITTLE VILLAGE COMMUNITY MENTAL HEALTH CENTER, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. FRANCISCO CISNEROS MA, CADC (EXECUTIVE DIRECTOR)
(773) 579-0832
Entity
Organization
Contact information
Practice address
1633 N 37TH AVE, MELROSE PARK, IL 60160-1723
(708) 343-7860
(708) 343-7895
Mailing address
2319 S DAMEN AVE, CHICAGO, IL 60608-4209
(773) 579-0832
(773) 579-0762
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A-0155-0003-A
STATE GRANT
IL
05
—
A-0155-0003-A
—
IL
Enumeration date
01/31/2008
Last updated
04/09/2021
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