Organization
WELLLIFE-A SUBSIDIARY OF INNOVATIVE SUSTAINABLE SOLUTIONS
Active
Parent organization
INNOVATIVE SUSTAINABLE SOLUTIONS
Organization subpart
Yes
Provider details
NPI number
Legal business name
INNOVATIVE SUSTAINABLE SOLUTIONS
Authorized official
MR. ANDRE MCCLERKLIN MDIV (CEO)
(773) 531-5163
Entity
Organization
Contact information
Practice address
15808 CLIFTON PARK AVE, MARKHAM, IL 60428-3921
(773) 531-5163
Mailing address
15808 CLIFTON PARK AVE, MARKHAM, IL 60428-3921
(773) 531-5163
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
IL
Other
Enumeration date
08/24/2011
Last updated
09/01/2011
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