Organization
NICASA NFP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LINDA SNELTEN (COO)
(847) 546-6450
Entity
Organization
Contact information
Practice address
31979 N FISH LAKE RD, ROUND LAKE, IL 60073-9517
(847) 546-6450
(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
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
14012
IL
Other
Enumeration date
04/22/2015
Last updated
04/07/2021
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