# JESUS GROUP HOME LLC.

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1730560434
- **Authorized official:** ZULY MARTINEZ HHA (CEO)
- **Authorized official phone:** (786) 266-6852

## Contact information

- **Practice address:** 15504 SW 104TH AVE, MIAMI, FL 33157-1458
- **Practice address phone:** (786) 592-2281
- **Mailing address:** 15504 SW 104TH AVE, MIAMI, FL 33157-1458
- **Mailing address phone:** (786) 592-2281

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 320600000X | Intellectual and/or Developmental Disabilities Residential Treatment Facility | — | NULL | Yes |

## Other

- **Enumeration date:** 06/18/2015
- **Last updated:** 06/18/2015