Provider Demographics
NPI:1346888781
Name:TOTAL ENRICHMENT SERVICES INC.
Entity Type:Organization
Organization Name:TOTAL ENRICHMENT SERVICES INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MELANEICE
Authorized Official - Middle Name:
Authorized Official - Last Name:SERCYE
Authorized Official - Suffix:
Authorized Official - Credentials:MSW/LSW
Authorized Official - Phone:708-368-5810
Mailing Address - Street 1:4941 W CHICAGO AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60651-3143
Mailing Address - Country:US
Mailing Address - Phone:773-403-1162
Mailing Address - Fax:888-400-2221
Practice Address - Street 1:3335 W WASHINGTON BLVD
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60624-2454
Practice Address - Country:US
Practice Address - Phone:773-403-1162
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-17
Last Update Date:2019-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)