| South Suburban Senior Socialites, Inc | |
|
17303 Hawthorne Dr Hazel Crest IL 60429-1838 | |
| (708) 466-8853 | |
| Not Available |
| Full Name | South Suburban Senior Socialites, Inc |
|---|---|
| Speciality | Psychologist - Group Psychotherapy |
| Location | 17303 Hawthorne Dr, Hazel Crest, Illinois |
| Authorized Official Name and Position | Marlayna Antionette Warren (PRESIDENT) |
| Authorized Official Contact | 7084668853 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| South Suburban Senior Socialites, Inc 17303 Hawthorne Dr Hazel Crest IL 60429-1838 Ph: (708) 466-8853 | South Suburban Senior Socialites, Inc 17303 Hawthorne Dr Hazel Crest IL 60429-1838 Ph: (708) 466-8853 |
| NPI Number | 1740421296 |
|---|---|
| Provider Enumeration Date | 03/12/2009 |
| Last Update Date | 03/12/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740421296 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TP2701X | Psychologist - Group Psychotherapy | (* (Not Available)) | Primary |
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