Provider Demographics
NPI:1255599213
Name:S AND N COMPREHENSIVE SERVICE CONSULTANTS
Entity type:Organization
Organization Name:S AND N COMPREHENSIVE SERVICE CONSULTANTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR/PROPRIETOR
Authorized Official - Prefix:MS
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:VANESSA
Authorized Official - Last Name:MOORE
Authorized Official - Suffix:
Authorized Official - Credentials:MSHSA
Authorized Official - Phone:708-824-9812
Mailing Address - Street 1:12517 S QUINN DR
Mailing Address - Street 2:
Mailing Address - City:ALSIP
Mailing Address - State:IL
Mailing Address - Zip Code:60803-1098
Mailing Address - Country:US
Mailing Address - Phone:708-824-9812
Mailing Address - Fax:
Practice Address - Street 1:12517 S QUINN DR
Practice Address - Street 2:
Practice Address - City:ALSIP
Practice Address - State:IL
Practice Address - Zip Code:60803-1098
Practice Address - Country:US
Practice Address - Phone:708-824-9812
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-27
Last Update Date:2008-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180006839251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health