Provider Demographics
NPI:1396467106
Name:MARTEM LLC
Entity type:Organization
Organization Name:MARTEM LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ESTHER
Authorized Official - Middle Name:OLAYINKA
Authorized Official - Last Name:AWOSOGBA
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:347-335-4884
Mailing Address - Street 1:1325 DAJA LN APT 1306
Mailing Address - Street 2:
Mailing Address - City:GRAND PRAIRIE
Mailing Address - State:TX
Mailing Address - Zip Code:75050-7651
Mailing Address - Country:US
Mailing Address - Phone:469-625-7208
Mailing Address - Fax:
Practice Address - Street 1:821 POPPIE LN
Practice Address - Street 2:
Practice Address - City:MIDLOTHIAN
Practice Address - State:TX
Practice Address - Zip Code:76065-2798
Practice Address - Country:US
Practice Address - Phone:469-625-7208
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-19
Last Update Date:2024-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes253Z00000XAgenciesIn Home Supportive CareGroup - Multi-Specialty
No171WV0202XOther Service ProvidersContractorVehicle ModificationsGroup - Multi-Specialty
No251C00000XAgenciesDay Training, Developmentally Disabled Services
No251E00000XAgenciesHome Health
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Multi-Specialty