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Organization
KIDS HOPE UNITED NORTHERN REGION
Active
Organization
KIDS HOPE UNITED NORTHERN REGION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HEATHER CHRISTINE KELLY (ASSISTANT DIRECTOR OF BH)
(217) 347-5880
Entity
Organization
Contact information
Practice address
215 N MILWAUKEE AVE, LAKE VILLA, IL 60046-8529
(847) 245-6584
(847) 356-1842
Mailing address
215 N MILWAUKEE AVE, P.O. BOX 1128, LAKE VILLA, IL 60046-8529
(847) 245-6584
(847) 356-1842
Taxonomy
Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
004019-10
IL
Other
Enumeration date
04/07/2006
Last updated
08/16/2024
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