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Organization
MSTOA STAFFING
Active
Organization
MSTOA STAFFING
Active
Other names
Moorish Science Temple of America
Organization subpart
No
Provider details
NPI number
Authorized official
MS. LATRICIA WALTONEL RMA (ASSISTANT MANAGER)
(773) 309-8749
Entity
Organization
Contact information
Practice address
353 S CICERO AVE, CHICAGO, IL 60644-4905
(773) 309-8749
Mailing address
353 S CICERO AVE, CHICAGO, IL 60644-4905
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
253Z00000X
IL
Other
Enumeration date
09/19/2011
Last updated
09/19/2011
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