Provider Demographics
NPI:1689886251
Name:SALVATION ARMY METRO DIVISION
Entity Type:Organization
Organization Name:SALVATION ARMY METRO DIVISION
Other - Org Name:THE SALVATION ARMY FAMILY AND COMMUNITY SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:
Authorized Official - Last Name:LEPSE
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:773-275-6233
Mailing Address - Street 1:4800 N MARINE DR
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60640-7859
Mailing Address - Country:US
Mailing Address - Phone:773-275-6233
Mailing Address - Fax:773-275-6288
Practice Address - Street 1:4800 N MARINE DR
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60640-7859
Practice Address - Country:US
Practice Address - Phone:773-275-6233
Practice Address - Fax:773-275-6288
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-04
Last Update Date:2008-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty