Organization
S&C ENTERPRISE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CLYDE PAYNE III (DIRECTOR)
(708) 474-8433
Entity
Organization
Contact information
Practice address
17842 PARK AVE, LANSING, IL 60438-1937
(708) 474-8433
Mailing address
17842 PARK AVE, LANSING, IL 60438-1937
(708) 474-8433
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
—
—
252Y00000X
Early Intervention Provider Agency
Primary
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
Other
Enumeration date
11/30/2009
Last updated
11/30/2009
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