Organization
CATHOLIC CHARITIES OF THE ARCHDIOCESE OF CHICAGO
Active
Parent organization
CATHOLIC CHARITIES OF THE ARCHDIOCESE OF CHICAGO
Other names
Lake County Behavioral Health Services
Organization subpart
Yes
Provider details
NPI number
Legal business name
CATHOLIC CHARITIES OF THE ARCHDIOCESE OF CHICAGO
Authorized official
MICHAEL M BOLAND MSW (ADMINISTRATOR, PRESIDENT AND CEO)
(312) 655-7320
Entity
Organization
Contact information
Practice address
671 S LEWIS AVE, WAUKEGAN, IL 60085-6101
(847) 782-4154
(847) 782-1030
Mailing address
671 S LEWIS AVE, WAUKEGAN, IL 60085-6101
(847) 782-4154
(847) 782-1030
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
101YP2500X
Professional Counselor
—
—
251B00000X
Case Management Agency
—
—
251E00000X
Home Health Agency
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
04019
IL
343900000X
Non-emergency Medical Transport (VAN)
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04019
—
IL
Enumeration date
04/10/2014
Last updated
12/28/2023
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