Aunt Martha's Youth Service Center, Inc.
NPI #1104054386 in Hazel Crest, Illinois
Provider Information
- NPI Number
- 1104054386
- Entity Type
- Organization
- Organization Name
- Aunt Martha's Youth Service Center, Inc.
- Primary Specialty
- Clinic/Center - Federally Qualified Health Center (FQHC)
- Enumeration Date
- Jun 26, 2009
- Last Updated
- Dec 2, 2010
Practice Location
- Address
- 17850 KEDZIE AVE
- Address 2
- SUITE 3200
- City
- Hazel Crest
- State
- Illinois
- ZIP Code
- 60429-2058
- Phone
- (708) 335-5201
Authorized Official
- Name
- MR. CHRISTOPHER J NORDLOH
- Title
- CFO
- Phone
- (708) 747-7100
Specialties & Taxonomy Codes
| Specialty |
|---|
| Clinic/Center - Federally Qualified Health Center (FQHC) — Federally Qualified Health Center (FQHC) |
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