Healthcare Provider Details

I. General information

NPI: 1063748127
Provider Name (Legal Business Name): ONE HOPE UNITED
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/26/2009
Last Update Date: 08/27/2024
Certification Date: 08/27/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1750 E MAIN ST SUITE 40
ST CHARLES IL
60174-2363
US

IV. Provider business mailing address

1750 E MAIN ST SUITE 40
ST CHARLES IL
60174-2363
US

V. Phone/Fax

Practice location:
  • Phone: 630-513-6277
  • Fax:
Mailing address:
  • Phone: 630-513-6277
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code253J00000X
TaxonomyFoster Care Agency
License Number37069157003
License Number StateIL
# 3
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: HEATHER CHRISTINE KELLY
Title or Position: ASST DIRECTOR OF BEHAVIORAL HEALTH
Credential:
Phone: 217-347-5880