Organization
AUNT MARTHA'S YOUTH SERVICE CENTER, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AUDREY PENNINGTON (EXECUTIVE VP OF HEALTH)
(773) 802-7645
Entity
Organization
Contact information
Practice address
15420 DIXIE HWY, HARVEY, IL 60426-3478
(877) 692-8686
Mailing address
19990 GOVERNORS HWY, OLYMPIA FIELDS, IL 60461-1021
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Enumeration date
10/10/2016
Last updated
10/10/2016
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