Organization
HIGHER LOVE PSR SPECIAL SRVC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KENNIE DELT (DIRECTOR)
(773) 768-7284
Entity
Organization
Contact information
Practice address
2705 E 83RD ST, CHICAGO, IL 60617-2007
(773) 768-7284
Mailing address
134 DEVONSHIRE DR, CRETE, IL 60417-1980
(773) 768-7284
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
5678
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
432029080001
—
IL
Enumeration date
04/28/2008
Last updated
04/28/2008
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