| NPI | 1053503094 |
|---|---|
| Doing Business As | SOUTHSTAR SERVICES |
| Entity Type | Organization |
| Authorized Contact | GUS VAN DEN BRINK President/CEO 708-730-6216 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 251C00000X Day Training, Developmentally Disabled Services (Licence: IL 946232) |
| 251S00000X Community/Behavioral Health | |
| 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: IL 946232) | |
| 320800000X Community Based Residential Treatment Facility, Mental Illness | |
| Enumeration Date | 2007-08-14 |
| Last Update Date | 2024-02-12 |