Organization
AUNT MARTHA'S YOUTH SERVICE CENTER, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CHRISTOPHER J NORDLOH (CFO)
(708) 747-7100
Entity
Organization
Contact information
Practice address
2614 SAINT CHARLES RD, BELLWOOD, IL 60104-1565
(708) 747-7100
Mailing address
19990 GOVERNORS HWY, OLYMPIA FIELDS, IL 60461-1021
(708) 747-7100
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
04/29/2009
Last updated
12/03/2010
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