Southwest Community Services, Inc.

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

License

04128 Issued in IL

Legal business name

SOUTHWEST COMMUNITY SERVICES, INC.

Practice address

58 W 162ND St
South Holland, IL 60473-2061

Phone

(708) 825-1986

NPI assigned

Oct 16, 2012

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Mary Pat Ambrosino

Title

Executive Director

Phone

(708) 429-1260

Specialties & licenses 1

Addresses

Tax ID family

Southwest Community Services Inc3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

• Southwest Community Services, Inc.

  • Non-emergency Medical Transport (VAN)
  • South Holland, IL
  • NPI 1033462288
  NPD tax ID
• Southwest Community Services, Inc.

  • Community/Behavioral Health Agency
  • Tinley Park, IL
  • NPI 1457647026
  NPD tax ID

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1350345600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1350345600000",
    "number": "1730432733",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6775 PROSPERI DR",
            "city": "TINLEY PARK",
            "state": "IL",
            "postal_code": "604774789",
            "telephone_number": "708-429-1260",
            "fax_number": "708-429-9107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "58 W 162ND ST",
            "city": "SOUTH HOLLAND",
            "state": "IL",
            "postal_code": "604732061",
            "telephone_number": "708-825-1986"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHWEST COMMUNITY SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-10-16",
        "last_updated": "2012-10-16",
        "status": "A",
        "authorized_official_last_name": "AMBROSINO",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "PAT",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "708-429-1260",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "IL",
            "license": "04128",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• South Park Dental Care
• South Park Pediatrics, Inc
• South Park Pediatrics, Inc
• South Suburban Physical Therapy LTD
• Southwest Community Services, Inc.
• Glendolyn Spencer
• Kimberly N Spencer, LCPC
• St Margaret Mercy Healthcare Centers, Inc.
• Miriam Standberry-Sanders
• Miranda Standberry-Wallace

• Mental Health Clinic/Center (Including Community Mental Health Center) in South Holland, IL
• Providers in South Holland, IL by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.