| Aunt Martha's Youth Service Center Inc | |
|
1777 E Court St Kankakee IL 60901-2670 | |
| (815) 937-0100 | |
| (815) 937-1823 |
| Full Name | Aunt Martha's Youth Service Center Inc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 1777 E Court St, Kankakee, Illinois |
| Authorized Official Name and Position | Christopher J Nordloh (CHIEF FINANCIAL OFFICER) |
| Authorized Official Contact | 7087477100 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Aunt Martha's Youth Service Center Inc 19990 Governors Hwy Olympia Fields IL 60461-1021 Ph: (708) 747-7100 | Aunt Martha's Youth Service Center Inc 1777 E Court St Kankakee IL 60901-2670 Ph: (815) 937-0100 |
| NPI Number | 1396070520 |
|---|---|
| Provider Enumeration Date | 10/06/2009 |
| Last Update Date | 12/02/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396070520 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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