Organization
CHINESE AMERICAN SERVICE LEAGUE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JERED G PRUITT (COO)
(312) 328-6606
Entity
Organization
Contact information
Practice address
2141 S TAN CT, CHICAGO, IL 60616-1998
(312) 808-0280
Mailing address
2141 S TAN CT, CHICAGO, IL 60616-1998
(312) 808-0280
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
—
—
1041C0700X
Clinical Social Worker
—
—
224Z00000X
Occupational Therapy Assistant
—
—
225X00000X
Occupational Therapist
—
—
261QH0100X
Health Service Clinic/Center
—
—
261QM0850X
Adult Mental Health Clinic/Center
Primary
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
363LF0000X
Family Nurse Practitioner
—
—
Other
Enumeration date
11/29/2022
Last updated
04/02/2024
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