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CH05887J COUNTY OF LAKE (Active)
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Main Details
Name
COUNTY OF LAKE
Subdivision Name
Libertyville Behavioral Health Home
Type
HRSA-Funded Health Center
Site ID
BPS-H80-014336
340B ID
CH05887J
Grant Number
H80CS00119
Additional Details
Current Program Status
Active
Registration Date
4/15/2015
Participating Start Date
7/1/2015
Participating Approval Date
5/1/2015
Last Recertification Date
2/11/2025
Contacts
Authorizing Official
County of Lake
Chris Hoff, Executive Director
(847) 377-8327
Primary Contact
Lake County Health Department
Angela L Smith, Clinical Compliance Manager
(847) 377-8346
Addresses
Street Address
18698 W Peterson Road
Libertyville, IL 60048
Billing Address
Lake County Health Department and Community Health Center
3010 Grand Avenue
3rd Floor
Waukegan, IL 60085
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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