Aunt Marthas Youth Service Center INC
NPI #1619104098 in Olympia Fields, Illinois
Provider Information
- NPI Number
- 1619104098
- Entity Type
- Organization
- Organization Name
- Aunt Marthas Youth Service Center INC
- Primary Specialty
- Clinic/Center - Federally Qualified Health Center (FQHC)
- Enumeration Date
- Jun 12, 2009
- Last Updated
- Mar 22, 2011
Practice Location
- Address
- 19990 GOVERNORS HWY
- City
- Olympia Fields
- State
- Illinois
- ZIP Code
- 60461-1021
- Phone
- (708) 747-7100
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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