Aunt Martha's Youth Service Center
NPI #1174070676 in Blue Island, Illinois
Provider Information
- NPI Number
- 1174070676
- Entity Type
- Organization
- Organization Name
- Aunt Martha's Youth Service Center
- Primary Specialty
- Clinic/Center - Federally Qualified Health Center (FQHC)
- Enumeration Date
- Sep 1, 2016
- Last Updated
- Jan 13, 2017
Practice Location
- Address
- 12139 S. WESTERN AVE
- City
- Blue Island
- State
- Illinois
- ZIP Code
- 60406
- Phone
- (877) 692-8686
Authorized Official
- Name
- AUDREY PENNINGTON
- Title
- EXECUTIVE VP OF HEALTH
- Phone
- (773) 802-7645
Specialties & Taxonomy Codes
| Specialty |
|---|
| Clinic/Center - Federally Qualified Health Center (FQHC) — Federally Qualified Health Center (FQHC) |
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