Western Lake in Fox Lake - Community/behavioral Health
Western Lake - NPI 1992893010
Western Lake is a Community/behavioral Health in Fox Lake, Illinois. Western Lake practices all healthcare services and medical treatments related to Community/behavioral Health. The NPI Number for Western Lake is 1992893010. The last update date is 2008-07-16.
Western Lake's current location address is 21 W Grand Ave, Fox Lake, Illinois. You can contact this provider via phone number 8475879700 and fax number 8475878584. The mailing address for Western Lake is 21 W Grand Ave, Fox Lake, Illinois. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Western Lake |
|---|---|
| Address | 21 W Grand Ave, Fox Lake, Illinois |
| Phone Number | 8475879700 |
| Fax Number | 8475878584 |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | DIRECTOR/ |
|---|---|
| Authorized Official Name | Hedien Roy Jeff |
| Credentials | MA NCC CAD |
| Telephone Number | 8475879700 |
NPI Number Detail
| NPI Number | 1992893010 |
|---|---|
| Provider Enumeration Date | 2006-10-11 |
| Last Updated Date | 2008-07-16 |
Provider Mailing Address Detail
| Address | 21 W Grand Ave |
|---|---|
| City | Fox Lake |
| State | Illinois (IL) |
| Post Code | 600201209 |
| Phone Number | 8475879700 |
| Fax Number | 8475878584 |
Provider's Primary Taxonomy Detail
| Speciality | Community/behavioral Health |
|---|---|
| Taxonomy | 251S00000X |
| Licence No | A-1450-0002- |
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Definition: A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, intellectual disabilities, substance abuse and/or behavioral health services to individuals with those dis |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| A 1450 0002 A | DEPT OF HUMAN SERVICES OFFICE |
Post Comment/ Review Below
What is the Western Lake's unique identification number?
The Western Lake has been assigned the NPI (National Provider Identifier) Number 1992893010 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code serves as a unique identifier for the organization.
Could you please share the complete physical location address where Western Lake's facilities are situated?
The facilities of Western Lake are physically located at the following address: 21 W Grand Ave, Fox Lake, IL, 600201209.
What is Western Lake's area of expertise and its corresponding taxonomy classification?
The Western Lake's field of specialization is Community/behavioral Health, and it falls under the taxonomy code 251S00000X, which categorizes healthcare providers based on their areas of practice.
When was the Western Lake's 1992893010 issued?
The Western Lake's 1992893010 was issued on 2006-10-11.
As of what date were the details pertaining to Western Lake last refreshed?
The information related to the Western Lake, including its address, specialty, and other relevant details, was last updated on 2008-07-16.