National Provider Identifier Database

AUNT MARTHAS YOUTH SERVICE CENTER INC
Federally Qualified Health Center (FQHC)

A Federally Qualified Health Center (FQHC) is a community-based organization that provides comprehensive primary care and preventive care, including health, oral, and mental health/substance abuse services to persons of all ages, regardless of their ability to pay or health insurance status.


Contact Information

AUNT MARTHA'S YOUTH SERVICE CENTER, INC.
17850 KEDZIE AVE
SUITE 3200
HAZEL CREST, IL60429-2058
Phone: 708-335-5201
Fax:
Website:
Specialty Taxonomy Code
* Federally Qualified Health Center (FQHC) 261QF0400X

* Indicates primary specialty

NPI Profile & details for AUNT MARTHA'S YOUTH SERVICE CENTER, INC.

NPI Number 1104054386
Legal business name
LBN
AUNT MARTHA'S YOUTH SERVICE CENTER, INC.
Authorized official CHRISTOPHER NORDLOH - (CFO)
Entity Organization
Organization subpart No
Enumeration date 06/26/2009
Last updated 12/02/2010 - About 16 years ago
Sole proprietor1 Not specified
Identifiers n/a

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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