Provider Demographics
NPI:1295332781
Name:MARTHA'S HEALTH SERVICES, INC
Entity type:Organization
Organization Name:MARTHA'S HEALTH SERVICES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ATIM
Authorized Official - Middle Name:
Authorized Official - Last Name:TENDOH KIMBENG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:240-423-8469
Mailing Address - Street 1:8701 PARLIAMENT DR
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:22151-1224
Mailing Address - Country:US
Mailing Address - Phone:240-423-8469
Mailing Address - Fax:
Practice Address - Street 1:1818 NEW YORK AVE NE # DC
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20002-1848
Practice Address - Country:US
Practice Address - Phone:240-423-8469
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-07
Last Update Date:2023-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No385HR2060XRespite Care FacilityRespite CareRespite Care, Intellectual and/or Developmental Disabilities, Child