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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