Provider Demographics
NPI:1912660390
Name:CHRISTIAN SOCIAL SERVICES OF ILLINOIS
Entity Type:Organization
Organization Name:CHRISTIAN SOCIAL SERVICES OF ILLINOIS
Other - Org Name:CARITAS FAMILY SOLUTIONS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR OF BEHAVIORAL HEALTH
Authorized Official - Prefix:
Authorized Official - First Name:MEGAN
Authorized Official - Middle Name:NICOLE
Authorized Official - Last Name:KIRK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:618-213-8729
Mailing Address - Street 1:950 HARTMAN LN
Mailing Address - Street 2:
Mailing Address - City:O FALLON
Mailing Address - State:IL
Mailing Address - Zip Code:62269-7209
Mailing Address - Country:US
Mailing Address - Phone:618-406-4355
Mailing Address - Fax:
Practice Address - Street 1:950 HARTMAN LN
Practice Address - Street 2:
Practice Address - City:O FALLON
Practice Address - State:IL
Practice Address - Zip Code:62269-7209
Practice Address - Country:US
Practice Address - Phone:618-406-4355
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-21
Last Update Date:2021-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No251S00000XAgenciesCommunity/Behavioral Health
No253J00000XAgenciesFoster Care Agency
No322D00000XResidential Treatment FacilitiesResidential Treatment Facility, Emotionally Disturbed Children