Organization
YOUTH OUTREACH SERVICES
Active
Parent organization
YOUTH OUTREACH SERVICES
Organization subpart
Yes
Provider details
NPI number
Legal business name
YOUTH OUTREACH SERVICES
Authorized official
MR. RICK VELASQUEZ MSW (EXECUTIVE DIRECTOR)
(773) 777-7112
Entity
Organization
Contact information
Practice address
6417 W IRVING PARK RD, YOUTH OUTREACH SERVICES, CHICAGO, IL 60634-2437
(773) 777-7112
(773) 777-7059
Mailing address
2411 W CONGRESS PKWY, YOUTH OUTREACH SERVICES, CHICAGO, IL 60612-3534
(773) 777-7112
(773) 777-7611
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
A-0534-0005-A
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2B05-IPI-144
—
IL
Enumeration date
08/09/2016
Last updated
08/09/2016
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