Organization
KINGDOM LIVING OUTREACH SERVICES, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DORIS PALMER (EXECUTIVE DIRECTOR)
(708) 747-9399
Entity
Organization
Contact information
Practice address
20303 CRAWFORD AVE, SUITE 100, OLYMPIA FIELDS, IL 60461-1073
(708) 747-9399
(708) 747-1908
Mailing address
20303 CRAWFORD AVE STE 100, P.O.BOX 1213, MATTESON, IL 60443, OLYMPIA FIELDS, IL 60461-1173
(708) 747-9399
(708) 747-1908
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
A-5777-0001-A
IL
Other
Enumeration date
10/06/2009
Last updated
10/06/2009
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