Provider Demographics
NPI:1376385492
Name:CHRISTIAN SOCIAL SERVICES OF ILLINOIS
Entity type:Organization
Organization Name:CHRISTIAN SOCIAL SERVICES OF ILLINOIS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:GARY
Authorized Official - Middle Name:
Authorized Official - Last Name:HUELSMANN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:618-213-8700
Mailing Address - Street 1:8601 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:BELLEVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:62223-1719
Mailing Address - Country:US
Mailing Address - Phone:618-213-8700
Mailing Address - Fax:
Practice Address - Street 1:1901 S 4TH ST STE 22
Practice Address - Street 2:
Practice Address - City:EFFINGHAM
Practice Address - State:IL
Practice Address - Zip Code:62401-4162
Practice Address - Country:US
Practice Address - Phone:217-342-3970
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-10
Last Update Date:2024-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253J00000XAgenciesFoster Care Agency
No251S00000XAgenciesCommunity/Behavioral Health
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)