| 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 (CFO) | 
| 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 | 1538339411 | 
|---|---|
| Provider Enumeration Date | 03/06/2008 | 
| Last Update Date | 12/02/2010 | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1538339411 | NPI | - | NPPES | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary | 
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