| Aunt Martha's Youth Service Center, Inc. | |
|
15420 Dixie Hwy Harvey IL 60426-3478 | |
| (877) 692-8686 | |
| Not Available |
| Full Name | Aunt Martha's Youth Service Center, Inc. |
|---|---|
| Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
| Location | 15420 Dixie Hwy, Harvey, Illinois |
| Authorized Official Name and Position | Audrey Pennington (EXECUTIVE VP OF HEALTH) |
| Authorized Official Contact | 7738027645 |
| 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: () - | Aunt Martha's Youth Service Center, Inc. 15420 Dixie Hwy Harvey IL 60426-3478 Ph: (877) 692-8686 |
| NPI Number | 1205386638 |
|---|---|
| Provider Enumeration Date | 10/10/2016 |
| Last Update Date | 10/10/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205386638 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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