Organization
AUNT MARTHA'S YOUTH SERVICE CENTER, INC.
Active
Organization
AUNT MARTHA'S YOUTH SERVICE CENTER, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CHRISTOPHER J NORDLOH (CFO)
(708) 747-7100
Entity
Organization
Contact information
Practice address
17850 KEDZIE AVE, SUITE 3200, HAZEL CREST, IL 60429-2058
(708) 335-5201
Mailing address
19990 GOVERNORS HWY, OLYMPIA FIELDS, IL 60461-1021
(708) 747-7100
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Enumeration date
06/26/2009
Last updated
12/02/2010
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