Organization
CENTER ON HALSTED
Active
Other names
Horizons Community Services Inc
Organization subpart
No
Provider details
NPI number
Authorized official
MODESTO VALLE (CHIEF EXECUTIVE OFFICER)
(773) 472-6469
Entity
Organization
Contact information
Practice address
3656 N HALSTED ST, CHICAGO, IL 60613-4316
(773) 472-6469
(773) 472-6643
Mailing address
3656 N HALSTED ST, CHICAGO, IL 60613-4316
(773) 472-6469
(773) 472-6643
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
—
01634461
BCBS
IL
Enumeration date
05/03/2006
Last updated
10/21/2015
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