| Kingdom Living Outreach Services, Inc | |
|
20303 Crawford Ave Suite 100 Olympia Fields IL 60461-1073 | |
| (708) 747-9399 | |
| (708) 747-1908 |
| Full Name | Kingdom Living Outreach Services, Inc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 20303 Crawford Ave, Olympia Fields, Illinois |
| Authorized Official Name and Position | Doris Palmer (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 7087479399 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Kingdom Living Outreach Services, Inc 20303 Crawford Ave Ste 100 P.o.box 1213, Matteson, Il 60443 Olympia Fields IL 60461-1173 Ph: (708) 747-9399 | Kingdom Living Outreach Services, Inc 20303 Crawford Ave Suite 100 Olympia Fields IL 60461-1073 Ph: (708) 747-9399 |
| NPI Number | 1659606895 |
|---|---|
| Provider Enumeration Date | 10/06/2009 |
| Last Update Date | 10/06/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659606895 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | A-5777-0001-A (Illinois) | Primary |
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