| Mchenry County Mental Health Board | |
|
620 Dakota St Crystal Lake IL 60012-3732 | |
| (815) 455-2828 | |
| Not Available |
| Full Name | Mchenry County Mental Health Board |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 620 Dakota St, Crystal Lake, Illinois |
| Authorized Official Name and Position | Alexandria Lewis (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 8154552828 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mchenry County Mental Health Board 620 Dakota St Crystal Lake IL 60012-3732 Ph: (815) 455-2828 | Mchenry County Mental Health Board 620 Dakota St Crystal Lake IL 60012-3732 Ph: (815) 455-2828 |
| NPI Number | 1154579068 |
|---|---|
| Provider Enumeration Date | 09/04/2008 |
| Last Update Date | 09/04/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154579068 | NPI | - | NPPES |
| 014 | Medicaid | IL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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