Organization
BOLD SPARK, INC.
Active
Parent organization
BOLD SPARK, INC.
Other names
The Oaks Counseling Center
Organization subpart
Yes
Provider details
NPI number
Legal business name
BOLD SPARK, INC.
Authorized official
KAREN V. LIEBOLD (OWNER)
(630) 329-6709
Entity
Organization
Contact information
Practice address
820 S BARTLETT RD STE 106B, STREAMWOOD, IL 60107-2407
(224) 318-7554
Mailing address
218 GINGERBROOK LN, BARTLETT, IL 60103-4624
(630) 329-6709
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1245414465
NPI
—
Enumeration date
01/24/2024
Last updated
05/22/2024
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