NPI | 1811171143 |
---|---|
Doing Business As | AUNT MARTHAS SOUTHEAST SIDE COMMUNITY HEALTH CENTER |
Entity Type | Organization |
Authorized Contact | CHRISTOPHER J NORDLOH CFO 708-747-7100 |
Organization Subpart ? | No |
Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
Enumeration Date | 2007-12-21 |
Last Update Date | 2011-03-22 |