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Kevin Khamvongsa
Community/Behavioral Health Agency in Crystal Lake, Illinois
NPI 1467907170

Kevin Khamvongsa is a Community/Behavioral Health Agency based in Crystal Lake, IL. Kevin Khamvongsa practices in Crystal Lake, IL. The NPI Number for Kevin Khamvongsa is 1467907170 and holds a License No. S4S8C5H5 (Illinois).

The current practice location address for Kevin Khamvongsa is 145 S Virginia St, Crystal Lake, IL and can be reached out via phone at 815-444-9999.

Location: 145 S Virginia St, Crystal Lake, IL, 60014-7226
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1467907170
Provider Name
Kevin Khamvongsa
Credential
Provider Entity Type
Individual
Gender
Male
Address
145 S Virginia St, Crystal Lake, IL, 60014-7226
Phone Number
815-444-9999
Fax Number
Provider Enumeration Date
08/23/2016
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
145 S Virginia St
City
Crystal Lake
State
Illinois
Zip
60014-7226
Phone Number
815-444-9999
Fax Number
person
Provider Business Mailing Address Details
Address
145 S Virginia St
City
Crystal Lake
State
Illinois
Zip
60014-7226
Phone Number
815-444-9999
Fax Number
person
Provider's Taxonomy Details 1
Type
Agencies
Classification
Community/Behavioral Health
Speciality
-
Taxonomy
251S00000X
License No.
S4S8C5H5 (Illinois)
Definition
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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