# MARLEE'S GROUP HOME LLC

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

## Provider details

- **NPI number:** 1932609435
- **Authorized official:** YVENA VIXAMAR RN (OWNER/ MANAGER)
- **Authorized official phone:** (954) 600-9295

## Contact information

- **Practice address:** 3861 SW ROSSER BLVD, PORT SAINT LUCIE, FL 34953-7084
- **Practice address phone:** (954) 600-9295
- **Mailing address:** 3861 SW ROSSER BLVD, PORT SAINT LUCIE, FL 34953-7084
- **Mailing address phone:** (954) 600-9295

## Taxonomy

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

## Other

- **Enumeration date:** 02/20/2018
- **Last updated:** 02/20/2018