Organization · Type 2 NPI
Aunt Marthas Youth Service Center Inc
Federally Qualified Health Center (FQHC) · Watseka, IL
NPI number
1649417759
Active
Practice location
200 E Walnut St
Watseka, IL 60970-1356
Fax (708) 747-0710
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
About NPI 1649417759
Aunt Marthas Youth Service Center Inc's National Provider Identifier is 1649417759, issued on Jan 12, 2009. The primary taxonomy on file is Federally Qualified Health Center (FQHC) (261QF0400X), and the practice location is in Watseka, IL. The record was last updated on Mar 22, 2011.