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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
DR. FRANCISCO CISNEROS (PRESIDENT & CEO)
(773) 579-0832
Entity
Organization
Contact information
Practice address
2259 S DAMEN AVE, CHICAGO, IL 60608-4232
(773) 579-0832
(773) 579-0832
Mailing address
2319 S DAMEN AVE, CHICAGO, IL 60608-4209
(773) 579-0832
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
05
—
04113
—
IL
Enumeration date
02/02/2018
Last updated
04/09/2021
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