Provider Demographics
NPI:1194443267
Name:ONE HOPE UNITED
Entity type:Organization
Organization Name:ONE HOPE UNITED
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ASST. DIRECTOR OF BEHAVIORAL HEALTH
Authorized Official - Prefix:
Authorized Official - First Name:HEATHER
Authorized Official - Middle Name:CHRISTINE
Authorized Official - Last Name:KELLY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:217-273-5398
Mailing Address - Street 1:333 S WABASH AVE STE 2750
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60604-4264
Mailing Address - Country:US
Mailing Address - Phone:847-245-6598
Mailing Address - Fax:
Practice Address - Street 1:4805 BROADWAY ST STE C
Practice Address - Street 2:
Practice Address - City:MOUNT VERNON
Practice Address - State:IL
Practice Address - Zip Code:62864-6702
Practice Address - Country:US
Practice Address - Phone:618-228-1133
Practice Address - Fax:773-692-2323
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-16
Last Update Date:2024-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)