# MARTIN'S MANOR, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Martin's Manor, LLC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1639835374
- **Authorized official:** MR. DENNIS P MARTIN JR. MPA (OWNER/ADMINISTRATOR)
- **Authorized official phone:** (678) 499-8308

## Contact information

- **Practice address:** 909 RING NECKED CT, STOCKBRIDGE, GA 30281-4475
- **Practice address phone:** (678) 499-8308
- **Practice address fax:** (678) 884-5621
- **Mailing address:** 1740 HUDSON BRIDGE RD, STOCKBRIDGE, GA 30281-6331
- **Mailing address phone:** (678) 499-8308
- **Mailing address fax:** (678) 884-5621

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251E00000X | Home Health Agency | — | NULL | Yes |

## Other

- **Enumeration date:** 11/16/2021
- **Last updated:** 01/01/2022