AUNT MARTHA'S YOUTH SERVICE CENTER; NPI #1427508464

Contact Information

AUNT MARTHA'S YOUTH SERVICE CENTER

812 N LOGAN AVE
DANVILLE, IL 61832-3752

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

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

NPI #	`1427508464`
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	10/13/2016
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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