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.
45 W 111TH ST
CHICAGO, IL60628-4200
Phone: 877-692-8686
Fax: 708-747-8024
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 1780932061
Legal business name
LBN
AUNT MARTHA'S YOUTH SERVICE CENTER, INC.
Authorized official AUDREY PENNINGTON - (EXEC. VP OF HEALTH)
Entity Organization
Organization subpart No
Enumeration date 08/17/2012
Last updated 11/02/2016 - About 10 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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