Organization
MARTIN'S GROUP HOME, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALTHEA MARTIN DIRECTOR (DIRECTOR)
(786) 302-7389
Entity
Organization
Contact information
Practice address
12550 SW 219TH ST, MIAMI, FL 33170-2733
(305) 257-4108
(305) 257-4177
Mailing address
12550 SW 219TH ST, MIAMI, FL 33170-2733
(305) 257-4108
(305) 257-4177
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
688682596
—
FL
Enumeration date
01/25/2022
Last updated
01/25/2022
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