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General NPI Number Information
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NPI Number | 1669846010
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Entity Type | Organization
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Legal Business Name | LAWRENCE HALL
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Dates
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Enumeration Date | 11/23/2015
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Last Update Date | 11/23/2015
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Provider Practice Location Address
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Address Line | 2737 W PETERSON AVE
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City | CHICAGO
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State | IL
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Zip | 60659-3927
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Country | US
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Telephone | 773-728-0751
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Fax | 773-728-0751
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Provider Business Mailing Address
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Address Line | 2737 W PETERSON AVE
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City | CHICAGO
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State | IL
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Zip | 60659-3927
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Country | US
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Telephone | 773-728-0751
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Fax | 773-728-0751
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Authorized Official
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Title or Position | DIRECTOR OF STRATEGIC INITIATIVES
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Name | MS. RENEE MARIA LEHOCKY
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Credential | LCSW
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Telephone | 773-334-7304
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number | 01223110
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 253J00000X
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Taxonomy Name | Foster Care Agency
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License Number | 01223110
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License Number State | IL
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