Provider Demographics
NPI:1093445165
Name:MARTHA JEFFERSON HOUSE
Entity Type:Organization
Organization Name:MARTHA JEFFERSON HOUSE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:HEATHER
Authorized Official - Middle Name:JOANNA
Authorized Official - Last Name:PARROTT
Authorized Official - Suffix:
Authorized Official - Credentials:DHSC, LNHA, CCC-SLP
Authorized Official - Phone:540-360-3027
Mailing Address - Street 1:1600 GORDON AVE
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22903-1944
Mailing Address - Country:US
Mailing Address - Phone:434-293-6136
Mailing Address - Fax:
Practice Address - Street 1:1600 GORDON AVE
Practice Address - Street 2:
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22903-1944
Practice Address - Country:US
Practice Address - Phone:434-293-6136
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-13
Last Update Date:2022-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty