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General NPI Number Information
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NPI Number | 1508580671
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Entity Type | Organization
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Legal Business Name | TOTAL ENRICHMENT SERVICES INC.
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Dates
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Enumeration Date | 10/03/2022
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Last Update Date | 10/03/2022
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Provider Practice Location Address
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Address Line | 5834 W AUGUSTA BLVD
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City | CHICAGO
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State | IL
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Zip | 60651-2510
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Country | US
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Telephone | 773-403-1162
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Fax |
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Provider Business Mailing Address
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Address Line | 1119 N MASON AVE
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City | CHICAGO
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State | IL
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Zip | 60651-2507
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Country | US
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Telephone | 773-403-1162
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | MELANEICE SERCYE
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Credential | LMSW
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Telephone | 708-368-5810
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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