Organization
AUNT MARTHA'S YOUTH SERVICE CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. AUDREY A PENNINGTON (CHIEF OPERATIONS OFFICER)
(877) 692-8686
Entity
Organization
Contact information
Practice address
440 FOREST BLVD, PARK FOREST, IL 60466-2002
(708) 747-7100
(708) 747-0710
Mailing address
19990 GOVERNORS HWY, OLYMPIA FIELDS, IL 60461-1021
(708) 747-7100
(708) 747-0710
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
12/04/2008
Last updated
09/15/2022
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