Provider Demographics
NPI:1225346901
Name:MARTIN'S ACHIEVEMENT PLACE, INC.
Entity Type:Organization
Organization Name:MARTIN'S ACHIEVEMENT PLACE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:LAYNEE
Authorized Official - Middle Name:
Authorized Official - Last Name:KUHN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:916-967-6253
Mailing Address - Street 1:7806 UPLANDS WAY
Mailing Address - Street 2:
Mailing Address - City:CITRUS HEIGHTS
Mailing Address - State:CA
Mailing Address - Zip Code:95610
Mailing Address - Country:US
Mailing Address - Phone:916-967-6253
Mailing Address - Fax:916-967-9413
Practice Address - Street 1:7806 UPLANDS WAY
Practice Address - Street 2:
Practice Address - City:CITRUS HEIGHTS
Practice Address - State:CA
Practice Address - Zip Code:95610
Practice Address - Country:US
Practice Address - Phone:916-967-6253
Practice Address - Fax:916-967-9413
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-16
Last Update Date:2017-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251S00000X
CA251S00000X, 322D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No322D00000XResidential Treatment FacilitiesResidential Treatment Facility, Emotionally Disturbed Children