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Organization
NICASA, NFP
Active
Organization
NICASA, NFP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LINDA SNELTEN (CHIEF OPERATING OFFICER)
(847) 546-6450
Entity
Organization
Contact information
Practice address
1724 1ST ST, HIGHLAND PARK, IL 60035-3202
(847) 433-1303
(847) 546-6760
Mailing address
31979 N FISH LAKE RD, ROUND LAKE, IL 60073-9517
(847) 546-6450
(847) 546-6760
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
A-0614-0006
IL
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
—
—
Other
Enumeration date
02/05/2014
Last updated
04/06/2021
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