ALLENDALE ASSOCIATION NPI 1821051608

NPI Information

NPI: 1821051608
Provider Name: ALLENDALE ASSOCIATION
Classification: Clinic/Center - 261QM0801X
Entity Type: Organization

Specialization: Mental Health (Including Community Mental Health Center)

CLIA Number: 14D2082728

Address:
GRAND AVE. AND OFFIELD DR.
LAKE VILLA, IL
ZIP 60046
Phone: (847) 356-2351
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ALLENDALE ASSOCIATION is a mental health (including community mental health center) clinic center in Lake Villa, IL. ALLENDALE ASSOCIATION NPI is 1821051608. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

GRAND AVE. AND OFFIELD DR.
LAKE VILLA, IL
ZIP 60046-088
Phone: (847) 356-2351
Fax: (847) 356-2393

The provider's authorized official is Christopher Anthony Schrantz .
The authorized official title is Chief Financial Officer and has the following contact phone number (847) 245-6214.

The CLIA number assigned to this NPI record is 14D2082728 - other - residential trmt ctr with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 4/11/2006 and was last updated on 7/21/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	2084P0804X	Psychiatry & Neurology	Child & Adolescent Psychiatry			No
2	261QM0801X	Clinic/Center	Mental Health (Including Community Mental Health Center)	001	ILLINOIS	No
3	261QM0855X	Clinic/Center	Adolescent and Children Mental Health	001300-10	ILLINOIS	No
4	322D00000X	Residential Treatment Facility, Emotionally Disturbed Children				No
5	261QM0801X	Clinic/Center	Mental Health (Including Community Mental Health Center)			Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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