Provider Demographics
NPI:1154178499
Name:PSG SERVICES, LLC
Entity type:Organization
Organization Name:PSG SERVICES, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:BERNARD
Authorized Official - Middle Name:D
Authorized Official - Last Name:BULGER
Authorized Official - Suffix:
Authorized Official - Credentials:ADMINISTRATOR
Authorized Official - Phone:708-422-2934
Mailing Address - Street 1:12855 S CICERO AVE STE 200
Mailing Address - Street 2:
Mailing Address - City:ALSIP
Mailing Address - State:IL
Mailing Address - Zip Code:60803-3043
Mailing Address - Country:US
Mailing Address - Phone:708-422-2934
Mailing Address - Fax:866-625-9406
Practice Address - Street 1:12855 S CICERO AVE STE 200
Practice Address - Street 2:
Practice Address - City:ALSIP
Practice Address - State:IL
Practice Address - Zip Code:60803-3043
Practice Address - Country:US
Practice Address - Phone:708-422-2934
Practice Address - Fax:866-625-9406
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PSG SERVICES, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-05-03
Last Update Date:2024-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based