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General NPI Number Information
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NPI Number | 1831119767
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Entity Type | Organization
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Legal Business Name | FAMILY SERVICE AND MENTAL HEALTH CENTER OF CICERO
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Dates
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Enumeration Date | 07/21/2006
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Last Update Date | 08/14/2024
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Provider Practice Location Address
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Address Line | 5341 W CERMAK RD
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City | CICERO
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State | IL
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Zip | 60804-2817
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Country | US
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Telephone | 708-656-6430
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Fax | 708-656-6591
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Provider Business Mailing Address
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Address Line | 5341 W CERMAK RD
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City | CICERO
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State | IL
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Zip | 60804-2817
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Country | US
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Telephone | 708-656-6430
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Fax | 708-656-6591
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | LORENA NAVARRETE
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Credential |
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Telephone | 708-656-6430
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State | IL
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Taxonomy #3
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Taxonomy Code | 251V00000X
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Taxonomy Name | Voluntary or Charitable Agency
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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