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Organization
AUNT MARTHAS YOUTH SERVICE CTR
Active
Organization
AUNT MARTHAS YOUTH SERVICE CTR
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GERALD GARVEY (CHIEF FINANCIAL OFFICER)
(708) 754-1044
Entity
Organization
Contact information
Practice address
233 W JOE ORR RD, CHICAGO HEIGHTS, IL 60411-1744
(708) 754-1044
Mailing address
440 FOREST BLVD, PARK FOREST, IL 60466-2002
(708) 679-8000
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
002
IL
Other
Enumeration date
05/31/2007
Last updated
07/21/2022
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