Organization
CHINESE AMERICAN SERVICE LEAGUE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JERED GREGORY PRUITT (CHIEF OPERATING OFFICER)
(312) 328-6606
Entity
Organization
Contact information
Practice address
2141 S TAN CT, CHICAGO, IL 60616-1998
(312) 791-0418
(312) 791-0509
Mailing address
2141 S TAN CT, CHICAGO, IL 60616-1998
(312) 791-0418
(312) 791-0509
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
—
—
1041C0700X
Clinical Social Worker
—
—
225X00000X
Occupational Therapist
—
—
253Z00000X
In Home Supportive Care Agency
—
—
261QA0600X
Adult Day Care Clinic/Center
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
341600000X
Ambulance
—
—
343900000X
Non-emergency Medical Transport (VAN)
—
—
363LF0000X
Family Nurse Practitioner
—
—
376J00000X
Homemaker
Primary
—
—
Other
Enumeration date
07/10/2012
Last updated
12/07/2023
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