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Contact Information

AUNT MARTHA'S YOUTH SERVICE CENTER
12139 S. WESTERN AVE
BLUE ISLAND, IL60406
 Phone: 877-692-8686
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Federally Qualified Health Center (FQHC)

261QF0400X B4[14] Federally Qualified Health Center
Indicates primary specialty

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

NPI Number 1174070676
LBN Legal business name AUNT MARTHA'S YOUTH SERVICE CENTER
Authorized official AUDREY PENNINGTON - (EXECUTIVE VP OF HEALTH)
Entity Organization
Organization subpart 1 No
Enumeration date 09/01/2016
Last updated 01/13/2017 - About 9 years ago
Identifiers n/a
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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