Organization · Type 2 NPI
Aunt Martha's Youth Service Center Inc
Federally Qualified Health Center (FQHC) · South Holland, IL
NPI number
1205067923
Active
Practice location
64 W 162nd St, Dental Suite
South Holland, IL 60473-2061
Mailing address
19990 Governors Hwy
Olympia Fields, IL 60461-1021
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Federally Qualified Health Center (FQHC) Primary | 261QF0400X | None listed |
Federally Qualified Health Center (FQHC): Definition to come...
Another provider at this address
Other federally qualified health center (fqhc) providers in South Holland
About NPI 1205067923
Aunt Martha's Youth Service Center Inc's National Provider Identifier is 1205067923, issued on Jul 29, 2009. The primary taxonomy on file is Federally Qualified Health Center (FQHC) (261QF0400X), and the practice location is in South Holland, IL. The record was last updated on Dec 2, 2010.