Provider Demographics
NPI:1225663479
Name:ELMHURST MENTAL HEALTH SERVICES, LLC
Entity Type:Organization
Organization Name:ELMHURST MENTAL HEALTH SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ALEXIS
Authorized Official - Middle Name:DANIEL
Authorized Official - Last Name:FIGUEROA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:630-286-9360
Mailing Address - Street 1:PO BOX 271
Mailing Address - Street 2:
Mailing Address - City:ELMHURST
Mailing Address - State:IL
Mailing Address - Zip Code:60126-0271
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:154 W PARK AVE UNIT 271
Practice Address - Street 2:
Practice Address - City:ELMHURST
Practice Address - State:IL
Practice Address - Zip Code:60126-6315
Practice Address - Country:US
Practice Address - Phone:630-286-9360
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-09
Last Update Date:2020-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty