Organization
AUNT MARTHA'S HEALTH AND WELLNESS, INC.
Active
Other names
Aunt Martha's Community Health Center - LSSI
Organization subpart
No
Provider details
NPI number
Authorized official
MS. AUDREY PENNINGTON (SR. DIRECTOR OF PATIENT ACCESS)
(773) 802-7645
Entity
Organization
Contact information
Practice address
4840 W BYRON ST # 60641, CHICAGO, IL 60641-2712
(877) 692-8686
(708) 747-8024
Mailing address
19990 GOVERNORS HWY, OLYMPIA FIELDS, IL 60461-1021
(877) 692-8686
(708) 747-8024
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
Other
Enumeration date
01/22/2022
Last updated
01/22/2022
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