SERTOMA STAR SERVICES INC. NPI 1629830815

NPI Information

  • NPI: 1629830815
  • Provider Name: SERTOMA STAR SERVICES, INC.
  • Classification: Clinic/Center - 261QM0801X
  • Specialization: Mental Health (Including Community Mental Health Center)
  • Entity Type: Organization
  • Address: 4331 LINCOLN HWY
    MATTESON, IL
    ZIP 60443
  • Phone: (708) 755-8030

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NPI Details

SERTOMA STAR SERVICES, INC. is a mental health (including community mental health center) clinic center in Matteson, IL. SERTOMA STAR SERVICES, INC. NPI is 1629830815. The provider is registered as an organization entity type.

The provider's business location address is:

4331 LINCOLN HWY
MATTESON, IL
ZIP 60443-404
Phone: (708) 755-8030

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 1/24/2024 and was last updated on 2/5/2024.

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
1251S00000XCommunity/Behavioral HealthNo
2320800000XCommunity Based Residential Treatment Facility, Mental IllnessNo
3261QM0801XClinic/CenterMental 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: 3/30/2025

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