# ONE HOPE UNITED- NORTHERN REGION

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Campus Building \#4
- **Organization subpart:** No

## Provider details

- **NPI number:** 1083961106
- **Authorized official:** HEATHER CHRISTINE KELLY (ASSISTANT DIRECTOR OF BH)
- **Authorized official phone:** (217) 347-5880

## Contact information

- **Practice address:** 215 N MILWAUKEE AVE, BUILDING \# 4, LAKE VILLA, IL 60046-8529
- **Practice address phone:** (847) 245-6500
- **Practice address fax:** (847) 356-1842
- **Mailing address:** 215 N MILWAUKEE AVE, P.O. BOX 1128, LAKE VILLA, IL 60046-8529
- **Mailing address phone:** (847) 245-6500
- **Mailing address fax:** (847) 356-1842

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 322D00000X | Emotionally Disturbed Childrens' Residential Treatment Facility | 004019-12 | IL | Yes |

## Other

- **Enumeration date:** 08/08/2012
- **Last updated:** 08/16/2024