Healthcare Provider Details

I. General information

NPI: 1821740721
Provider Name (Legal Business Name): SEASONS TOTAL CARE SOLUTIONS INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/21/2022
Last Update Date: 02/28/2023
Certification Date: 02/28/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16148 KEDZIE AVE
MARKHAM IL
60428-4603
US

IV. Provider business mailing address

16148 KEDZIE AVE
MARKHAM IL
60428-4603
US

V. Phone/Fax

Practice location:
  • Phone: 708-634-4047
  • Fax:
Mailing address:
  • Phone: 708-634-4047
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QC1500X
TaxonomyCommunity Health Clinic/Center
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State

VIII. Authorized Official

Name: FAYE DODSON
Title or Position: DIRECTOR
Credential:
Phone: 708-634-4047