Martha Assisted Living

Primary specialty

Assisted Living Facility (Mental Illness)Taxonomy code 3104A0625X

Legal business name

MARTHA ASSISTED LIVING

Practice address

3613 Dellabrooke St
Olney, MD 20832-1028

Phone

(301) 326-7425

Fax

(240) 833-3256

NPI assigned

May 12, 2022

Organization subpart

No

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

Authorized official

Name

Vidana JayawardanaNPI 1376289272

Title

Alm

Phone

(301) 326-7425

Specialties & licenses 1

Addresses

Other names 1

• MARTHA ASSISTED LIVING Doing business as

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Vidana A Jayawardana

  • Nurse's Aide
  • Olney, MD
  • NPI 1376289272
  NPD Authorized official

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

{
    "created_epoch": "1652313600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1652313600000",
    "number": "1942947817",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3613 DELLABROOKE ST",
            "city": "OLNEY",
            "state": "MD",
            "postal_code": "208321028",
            "telephone_number": "301-326-7425"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3613 DELLABROOKE ST",
            "city": "OLNEY",
            "state": "MD",
            "postal_code": "208321028",
            "telephone_number": "301-326-7425",
            "fax_number": "240-833-3256"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3609 Blankenship Ct",
            "address_purpose": "LOCATION",
            "city": "Olney",
            "state": "MD",
            "postal_code": "208321334",
            "country_code": "US",
            "telephone_number": "301-326-7425",
            "fax_number": "240-833-3256",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MARTHA ASSISTED LIVING",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-05-12",
        "last_updated": "2022-05-12",
        "certification_date": "2022-05-12",
        "status": "A",
        "authorized_official_last_name": "JAYAWARDANA",
        "authorized_official_first_name": "VIDANA",
        "authorized_official_title_or_position": "ALM",
        "authorized_official_telephone_number": "301-326-7425"
    },
    "taxonomies": [
        {
            "code": "3104A0625X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility, Assisted Living, Mental Illness",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MARTHA ASSISTED LIVING",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Glenn W Mann
• Joseph Mann, CRNP
• Emily E March, LGMFT
• Mechelle Marchant
• Frandi Mars, LCSW-C
• Leigh Kristi Martinez, MA, CCC-SLP
• Lourdes Martinez, M.AC L.AC
• Heidi Martino, SLP
• Mimi Pokua Martins, M.D
• Maryland CVS Pharmacy, L.L.C.

• Assisted Living Facility (Mental Illness) in Olney, MD
• Providers in Olney, MD by specialty
• Assisted Living Facility (Mental Illness) in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2022; 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.