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Contact Information

AUNT MARTHA'S HEALTH AND WELLNESS, INC.
420 NE GLEN OAK AVE FL 1
PEORIA, IL61603-3106
 Phone: 877-692-8686
 Fax: 708-747-8024
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Federally Qualified Health Center (FQHC)

261QF0400X B4[14] Federally Qualified Health Center
 

Mental Health (Including Community Mental Health Center)

261QM0801X B4[14] Community Mental Health Center
Indicates primary specialty

NPI Profile & details for AUNT MARTHA'S HEALTH AND WELLNESS, INC.

NPI # 1700539517
LBN Legal business name AUNT MARTHA'S HEALTH AND WELLNESS, INC.
Authorized official AUDREY PENNINGTON - (COO)
Entity Organization
Organization subpart 1 No
Enumeration date 02/01/2022
Last updated 02/01/2022 - About 4 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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