Marlee'S Group Home LLC

Primary specialty

Intellectual and/or Developmental Disabilities Residential Treatment FacilityTaxonomy code 320600000X

Legal business name

MARLEE'S GROUP HOME LLC

Practice address

3861 SW Rosser Blvd
Port Saint Lucie, FL 34953-7084

Phone

(954) 600-9295

NPI assigned

Feb 20, 2018

Organization subpart

No

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

Authorized official

Name

Yvena Vixamar, RN

Title

Owner/ Manager

Phone

(954) 600-9295

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1519084800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1519084800000",
    "number": "1932609435",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3861 SW ROSSER BLVD",
            "city": "PORT SAINT LUCIE",
            "state": "FL",
            "postal_code": "349537084",
            "telephone_number": "954-600-9295"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3861 SW ROSSER BLVD",
            "city": "PORT SAINT LUCIE",
            "state": "FL",
            "postal_code": "349537084",
            "telephone_number": "954-600-9295"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARLEE'S GROUP HOME LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-02-20",
        "last_updated": "2018-02-20",
        "status": "A",
        "authorized_official_last_name": "VIXAMAR",
        "authorized_official_first_name": "YVENA",
        "authorized_official_title_or_position": "OWNER/ MANAGER",
        "authorized_official_telephone_number": "954-600-9295",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Vanessa Marius, APRN (FNP-BC)
• Mark J. Pamer, D.O., L.L.C.
• Mark J. Pamer, D.O., L.L.C.
• Kaitlyn Markovich
• Chris Markuson
• Ernesto Alejandro Marrero Toledo
• Jessica Marsh
• Osvaldo Orgelio Martin Montejo
• Cavelline M. Martin-Darby, APRN/DNP
• Aidan Scott Martin, DC

• Intellectual and/or Developmental Disabilities Residential Treatment Facility in Port Saint Lucie, FL
• Providers in Port Saint Lucie, FL by specialty
• Intellectual and/or Developmental Disabilities Residential Treatment Facility in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2018; 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.