Organization
RINCON FAMILY SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EDDY BORRAYO (PRESIDENT/CEO)
(773) 564-9070
Entity
Organization
Contact information
Practice address
5453 W DIVERSEY AVE, CHICAGO, IL 60639-1413
(888) 215-0513
(773) 417-3293
Mailing address
3710 N KEDZIE AVE, CHICAGO, IL 60618-4504
(773) 564-9070
Taxonomy
Speciality
Code
Description
License number
State
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0488
—
IL
Enumeration date
06/13/2016
Last updated
11/01/2018
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