INDEPENDENCE CENTER, INC.

Community/Behavioral Health

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 disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment.

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Contact Information

INDEPENDENCE CENTER, INC.

2025 WASHINGTON ST
WAUKEGAN, IL 60085-5131

Phone: 847-360-1020
Fax: 847-360-1065
Website:

Specialty	Taxonomy Code	Specialty Code	Provider Type
Community/Behavioral Health	251S00000X
Adult Mental Health	261QM0850X
Case Management	251B00000X
Community Based Residential Treatment Facility, Mental Illness	320800000X
Mental Health (Including Community Mental Health Center)	261QM0801X	B4[14]	Community Mental Health Center

Indicates primary specialty

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NPI Profile & details for INDEPENDENCE CENTER, INC.

NPI # 1174709810

LBN Legal business name INDEPENDENCE CENTER, INC.

Authorized official LISA JOHNSON - (EXECUTIVE DIRECTOR)

Entity Organization

Organization subpart ¹ No

Enumeration date 01/11/2008

Last updated 11/04/2016 - About 10 years ago

Identifiers

Other

IL6331

MEDICARE PTAN

¹ Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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