Provider Demographics
NPI:1316130420
Name:S & S PROFESSIONALS, LLC
Entity type:Organization
Organization Name:S & S PROFESSIONALS, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TATJANA
Authorized Official - Middle Name:
Authorized Official - Last Name:SAVICH
Authorized Official - Suffix:
Authorized Official - Credentials:OT
Authorized Official - Phone:586-286-9644
Mailing Address - Street 1:42536 HAYES RD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:CLINTON TOWNSHIP
Mailing Address - State:MI
Mailing Address - Zip Code:48038-6766
Mailing Address - Country:US
Mailing Address - Phone:586-286-9644
Mailing Address - Fax:
Practice Address - Street 1:42536 HAYES RD
Practice Address - Street 2:SUITE 300
Practice Address - City:CLINTON TOWNSHIP
Practice Address - State:MI
Practice Address - Zip Code:48038-6766
Practice Address - Country:US
Practice Address - Phone:586-286-9644
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-22
Last Update Date:2007-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MID22496302F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302F00000XManaged Care OrganizationsExclusive Provider Organization