Provider Demographics
NPI:1184215048
Name:FAMILIES TOGETHER THERAPY SERVICES
Entity Type:Organization
Organization Name:FAMILIES TOGETHER THERAPY SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LOLA
Authorized Official - Middle Name:SHAOXUAN
Authorized Official - Last Name:WANG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:773-598-6698
Mailing Address - Street 1:2618 W FULLERTON AVE APT 3A
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60647-4086
Mailing Address - Country:US
Mailing Address - Phone:312-998-9232
Mailing Address - Fax:
Practice Address - Street 1:410 S MICHIGAN AVE STE 622
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60605-1452
Practice Address - Country:US
Practice Address - Phone:773-598-6698
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-02
Last Update Date:2021-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)Group - Multi-Specialty