CENTER ON HALSTED NPI 1508824244

NPI Information

CENTER ON HALSTED is a mental health (including community mental health center) clinic center in Chicago, IL. CENTER ON HALSTED NPI is 1508824244. The provider is registered as an organization entity type.
The provider Former Legal Business Name Is Horizons Community Services Inc.

The provider's business location address is:

3656 N HALSTED ST
CHICAGO, IL
ZIP 60613-316
Phone: (773) 472-6469
Fax: (773) 472-6643

The provider's authorized official is Modesto Valle .
The authorized official title is Chief Executive Officer and has the following contact phone number (773) 472-6469.

The CLIA number assigned to this NPI record is 14D1078925 - other with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 5/3/2006 and was last updated on 10/21/2015.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

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