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General NPI Number Information
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NPI Number | 1922331958
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Entity Type | Organization
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Legal Business Name | LAWRENCE HALL YOUTH SERVICES
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Dates
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Enumeration Date | 09/09/2009
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Last Update Date | 09/09/2009
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Provider Practice Location Address
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Address Line | 65 E WACKER PL 7TH FLOOR
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City | CHICAGO
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State | IL
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Zip | 60601-7296
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Country | US
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Telephone | 312-346-3383
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Fax | 312-346-6547
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Provider Business Mailing Address
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Address Line | 65 E WACKER PL 7TH FLOOR
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City | CHICAGO
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State | IL
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Zip | 60601-7296
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Country | US
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Telephone | 312-346-3383
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Fax | 312-346-6547
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Authorized Official
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Title or Position | CHIEF FINANCIAL OFFICER
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Name | MR. MARK DOUGLAS NUFER
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Credential | CPA
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Telephone | 773-728-2807
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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 | 012231-10
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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 | 012231-10
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License Number State | IL
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