Organization
RINCON FAMILY SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. EDDY BORRAYO (EXECUTIVE DIRECTOR)
(773) 564-9070
Entity
Organization
Contact information
Practice address
4720 N SHERIDAN RD, CHICAGO, IL 60640-5022
(844) 384-7371
(773) 250-6056
Mailing address
3710 N KEDZIE AVE, CHICAGO, IL 60618-4504
(773) 564-9070
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
14003
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
14003
—
IL
Enumeration date
06/13/2016
Last updated
06/13/2016
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