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Organization
FAMILY SERVICE AND MENTAL HEALTH CENTER OF CICERO
Active
Organization
FAMILY SERVICE AND MENTAL HEALTH CENTER OF CICERO
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LORENA NAVARRETE (OFFICE MANAGER)
(708) 656-6430
Entity
Organization
Contact information
Practice address
5341 W CERMAK RD, CICERO, IL 60804-2817
(708) 656-6430
(708) 656-6591
Mailing address
5341 W CERMAK RD, CICERO, IL 60804-2817
(708) 656-6430
(708) 656-6591
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
—
—
251S00000X
Community/Behavioral Health Agency
—
IL
251V00000X
Voluntary or Charitable Agency
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1098789
WELLCARE
IL
01
—
1179410
BEACON
IL
01
—
1617631
BLUE CROSS BLUE SHIELD
IL
01
—
5765456
AETNA
IL
01
—
B98842
HEALTH LINK
IL
01
—
QMP000002397118
MOLINA
IL
Enumeration date
07/21/2006
Last updated
08/14/2024
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