Martin Group Care Home

Primary specialty

Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X

License

13578712 Issued in MO

Legal business name

MARTIN GROUP CARE HOME

Practice address

3801 S Grand Ave
Sedalia, MO 65301-8705

Phone

(660) 827-7168

Fax

(660) 827-5372

NPI assigned

Jan 11, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ms. Kathleen Marie Martin

Title

Owner

Phone

(660) 827-7168

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1168473600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1780734996",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3801 S GRAND AVE",
            "city": "SEDALIA",
            "state": "MO",
            "postal_code": "653018705",
            "telephone_number": "660-827-7168",
            "fax_number": "660-827-5372"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3801 S GRAND AVE",
            "city": "SEDALIA",
            "state": "MO",
            "postal_code": "653018705",
            "telephone_number": "660-827-7168",
            "fax_number": "660-827-5372"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARTIN GROUP CARE HOME",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-11",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MARTIN",
        "authorized_official_first_name": "KATHLEEN",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "660-827-7168",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "MO",
            "license": "13578712",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mary Malan, RPH
• Teresa M Manlove, C.N.M.
• Whitney Morgan Marcum, FNP-BC
• Henry C. Marquez, M.D.
• Marsha Jane Kranichfield (LifeSupport Interventions)
• Joann Martin, APRN, CPNP
• Tiffany Suzanne Martin, L.C.S.W.
• Kayla Lorynn Mather, CNP
• Braeden Mathur, DDS
• Casey Eisenhower McCluskie, DC

• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Sedalia, MO
• Providers in Sedalia, MO by specialty
• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.