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Organization

AUNT MARTHA'S YOUTH SERVICE CENTER

Active
Other names
Aunt Martha's Vermilion West Community Health Center
Organization subpart
No

Provider details

NPI number
Authorized official
AUDREY PENNINGTON (EXECUTIVE VP OF HEALTH)
(773) 802-7645
Entity
Organization

Contact information

Practice address
812 N LOGAN AVE, DANVILLE, IL 61832-3752
(877) 692-8686
Mailing address
19900 GOVERNORS DR, OLYMPIA FIELDS, IL 60461-1057

Taxonomy

Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary

Other

Enumeration date
10/13/2016
Last updated
01/13/2017
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