SERTOMA STAR SERVICES INC. NPI 1053503094

NPI Information

NPI: 1053503094
Provider Name: SERTOMA STAR SERVICES, INC.

Doing Business As: SOUTHSTAR SERVICES

Classification: Clinic/Center - 261QM0801X
Entity Type: Organization

Specialization: Mental Health (Including Community Mental Health Center)

Address:
1005 W END AVE
CHICAGO HEIGHTS, IL
ZIP 60411
Phone: (708) 755-8030
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SERTOMA STAR SERVICES, INC. is a mental health (including community mental health center) clinic center in Chicago Heights, IL. SERTOMA STAR SERVICES, INC. NPI is 1053503094. The provider is registered as an organization entity type.
The provider Is Doing Business As Southstar Services.

The provider's business location address is:

1005 W END AVE
CHICAGO HEIGHTS, IL
ZIP 60411-742
Phone: (708) 755-8030
Fax: (708) 755-8047

The provider's authorized official is Gus Van Den Brink .
The authorized official title is President/ceo and has the following contact phone number (708) 730-6216.

The enumeration date for this NPI number is 8/14/2007 and was last updated on 2/12/2024.

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:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	251C00000X	Day Training, Developmentally Disabled Services		946232	ILLINOIS	No
2	251S00000X	Community/Behavioral Health				No
3	320600000X	Residential Treatment Facility, Intellectual and/or Developmental Disabilities		946232	ILLINOIS	No
4	320800000X	Community Based Residential Treatment Facility, Mental Illness				No
5	261QM0801X	Clinic/Center	Mental Health (Including Community Mental Health Center)			Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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