Organization
OUR PLACE SAFE SPACE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHASTITY SAUCER LCSW (LICENSED CLINICAL SOCIAL WORKER)
(312) 487-1715
Entity
Organization
Contact information
Practice address
5140 S HYDE PARK BLVD, CHICAGO, IL 60615
(312) 487-1715
Mailing address
1440 W TAYLOR ST # 1637, CHICAGO, IL 60607-4623
(312) 487-1715
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
08/13/2021
Last updated
08/13/2021
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