Organization
LAWRENCE HALL YOUTH SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MARK NUFER (CHIEF FINANCIAL OFFICER)
(773) 728-2807
Entity
Organization
Contact information
Practice address
6344 N LAKEWOOD AVE, CHICAGO, IL 60660-1408
(773) 728-2807
(773) 728-0751
Mailing address
2737 W PETERSON AVE, CHICAGO, IL 60659-3927
(773) 728-2807
(773) 728-0751
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
12057909
IL
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
12057909
IL
Other
Enumeration date
10/01/2012
Last updated
10/01/2012
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