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Sertoma Centre, INC.

Clinic/Center, Mental Health (Including Community Mental Health Center) in Alsip, IL. Organization (NPI-2).

NPI number1982201414
StatusActive
Last updated in NPPESOct 7, 2020

Details

NPI
1982201414
Entity type
Organization (NPI-2)
Legal business name
Sertoma Centre, INC.
Organization subpart
No
Enumeration date
Oct 7, 2020
Certification date
Oct 1, 2020
Last updated
Oct 7, 2020

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center)––Yes

Practice location

4343 W 123rd St
Alsip, IL 60803-1807

Phone 708-739-6216 · Fax 708-371-9700

Mailing address

4343 W 123rd St
Alsip, IL 60803-1807

Phone 708-739-6216 · Fax 708-371-9700

Authorized official

Gus Van Den Brink
Executive Director
7087306216

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