Organization
SOUTH SUBURBAN SENIOR SOCIALITES, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MARLAYNA ANTIONETTE WARREN (PRESIDENT)
(708) 466-8853
Entity
Organization
Contact information
Practice address
17303 HAWTHORNE DR, HAZEL CREST, IL 60429-1838
(708) 466-8853
Mailing address
17303 HAWTHORNE DR, HAZEL CREST, IL 60429-1838
(708) 466-8853
Taxonomy
Speciality
Code
Description
License number
State
103TP2701X
Group Psychotherapy Psychologist
Primary
—
—
Other
Enumeration date
03/12/2009
Last updated
03/12/2009
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