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
64 W 162ND ST
DENTAL SUITE
SOUTH HOLLAND, IL60473-2061
Phone: 708-747-7100
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 1205067923
Legal business name
LBN
AUNT MARTHA'S YOUTH SERVICE CENTER INC
Authorized official CHRISTOPHER NORDLOH - (CFO)
Entity Organization
Organization subpart No
Enumeration date 07/29/2009
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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