Organization
AUNT MARTHAS YOUTH SERVICE CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CHRISTOPHER J NORDLOH (CFO)
(708) 747-7100
Entity
Organization
Contact information
Practice address
19990 GOVERNORS HWY, OLYMPIA FIELDS, IL 60461-1021
(708) 747-7100
Mailing address
19990 GOVERNORS HWY, OLYMPIA FIELDS, IL 60461-1021
(708) 747-7100
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
IL
251C00000X
Developmentally Disabled Services Day Training Agency
—
IL
251J00000X
Nursing Care Agency
—
IL
251K00000X
Public Health or Welfare Agency
—
IL
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Enumeration date
05/17/2006
Last updated
12/02/2010
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