AUNT MARTHA'S HEALTH AND WELLNESS INC. NPI 1700539517

NPI Information

NPI: 1700539517
Provider Name: AUNT MARTHA'S HEALTH AND WELLNESS, INC.
Classification: Clinic/Center - 261QF0400X
Entity Type: Organization

Specialization: Federally Qualified Health Center (FQHC)

Address:
420 NE GLEN OAK AVE FL 1
PEORIA, IL
ZIP 61603
Phone: (877) 692-8686
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AUNT MARTHA'S HEALTH AND WELLNESS, INC. is a federally qualified health center (fqhc) clinic center in Peoria, IL. AUNT MARTHA'S HEALTH AND WELLNESS, INC. NPI is 1700539517. The provider is registered as an organization entity type.

The provider's business location address is:

420 NE GLEN OAK AVE FL 1
PEORIA, IL
ZIP 61603-106
Phone: (877) 692-8686
Fax: (708) 747-8024

The provider's authorized official is Audrey Pennington .
The authorized official title is Coo and has the following contact phone number (773) 802-7645.

The enumeration date for this NPI number is 2/1/2022 and was last updated on 2/1/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QM0801X	Clinic/Center	Mental Health (Including Community Mental Health Center)			No
2	261QF0400X	Clinic/Center	Federally Qualified Health Center (FQHC)			Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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