NPI 1083961106

One Hope United- Northern Region

Organisation Emotionally Disturbed Childrens' Residential Treatment Facility Lake Villa, IL

Practice location

Address: 215 N Milwaukee Ave Building # 4, Lake Villa, IL 60046-8529
Phone: (847) 245-6500
Fax: (847) 356-1842
Mailing address: 215 N Milwaukee Ave P.O. Box 1128, Lake Villa, IL 60046-8529

Authorised official

Name: Heather Christine Kelly
Title: Assistant Director of Bh
Phone: (217) 347-5880

Registered specialties

Emotionally Disturbed Childrens' Residential Treatment Facility Primary

Residential Treatment Facilities Taxonomy 322D00000X Licence 004019-12 (IL)

Other Residential Treatment Facility, Emotionally Disturbed Children providers in Illinois →

Registry record

NPI: 1083961106
Entity type: Organization
NPI issued: 8 Aug 2012
Record last updated: 16 Aug 2024

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.