Organization
YOUTH OUTREACH SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RICK VELASQUEZ MSW (EXECUTIVE DIRECTOR)
(773) 777-7112
Entity
Organization
Contact information
Practice address
6117 W CERMAK RD, CICERO, IL 60804-2023
(773) 777-7112
(708) 652-5379
Mailing address
2411 W CONGRESS PKWY, CHICAGO, IL 60612-3534
(773) 777-7112
(773) 777-7112
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
A-0534-0006-A
IL
Other
Enumeration date
01/06/2010
Last updated
01/06/2010
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