National Provider Identifier Database

INDEPENDENCE CENTER
Community Based Residential Treatment Facility, Mental Illness

A home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness.


Contact Information

INDEPENDENCE CENTER
819 INDIANA AVE
WAUKEGAN, IL60085-2612
Phone: 847-360-1020
Fax:
Website:
Specialty Taxonomy Code
* Community Based Residential Treatment Facility, Mental Illness 320800000X
Case Management 251B00000X
Community/Behavioral Health 251S00000X

* Indicates primary specialty

NPI Profile & details for INDEPENDENCE CENTER

NPI Number 1427227230
Legal business name
LBN
INDEPENDENCE CENTER
Authorized official MICHAEL PIERCE - (EXECUTIVE DIRECTOR)
Entity Organization
Organization subpart No
Enumeration date 02/26/2008
Last updated 08/03/2011 - About 15 years ago
Sole proprietor1 Not specified
Identifiers n/a

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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