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
MR. FRANCISCO CISNEROS MA, CADC (EXECUTIVE DIRECTOR)
(773) 579-0832
Entity
Organization
Contact information
Practice address
1546 N MANNHEIM RD, STONE PARK, IL 60165-1117
(708) 410-0856
(708) 410-0884
Mailing address
2319 S DAMEN AVE, CHICAGO, IL 60608-4209
(773) 579-0832
(773) 579-0762
Taxonomy
Speciality
Code
Description
License number
State
261QM2800X
Methadone Clinic
—
—
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A-0155-0004-A
STATE GRANTS
IL
05
—
A-0155-0004-A
—
IL
Enumeration date
01/31/2008
Last updated
02/07/2022
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up