Provider Demographics
NPI:1487324083
Name:4S WELLNESS SERVICES
Entity type:Organization
Organization Name:4S WELLNESS SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MARLAYNA
Authorized Official - Middle Name:ANTIONETTE
Authorized Official - Last Name:WARREN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:708-466-8853
Mailing Address - Street 1:305 WAYNE ST
Mailing Address - Street 2:
Mailing Address - City:PARK FOREST
Mailing Address - State:IL
Mailing Address - Zip Code:60466-1327
Mailing Address - Country:US
Mailing Address - Phone:708-466-8853
Mailing Address - Fax:708-367-9980
Practice Address - Street 1:305 WAYNE ST
Practice Address - Street 2:
Practice Address - City:PARK FOREST
Practice Address - State:IL
Practice Address - Zip Code:60466-1327
Practice Address - Country:US
Practice Address - Phone:708-466-8853
Practice Address - Fax:708-367-9980
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-15
Last Update Date:2021-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TP2701XBehavioral Health & Social Service ProvidersPsychologistGroup PsychotherapyGroup - Multi-Specialty