Provider Demographics
NPI:1457584245
Name:MARTIN ELDERLY CARE,INC
Entity Type:Organization
Organization Name:MARTIN ELDERLY CARE,INC
Other - Org Name:MARTIN ELDERLY CARE,INC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ASISTADE LIVING ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:LOUISE
Authorized Official - Middle Name:LEGER
Authorized Official - Last Name:ELISE
Authorized Official - Suffix:
Authorized Official - Credentials:LPN
Authorized Official - Phone:305-762-4242
Mailing Address - Street 1:901 NW 63RD ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33150-4220
Mailing Address - Country:US
Mailing Address - Phone:305-762-4242
Mailing Address - Fax:
Practice Address - Street 1:901 NW 63 ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33150
Practice Address - Country:US
Practice Address - Phone:305-762-4242
Practice Address - Fax:305-762-4242
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-27
Last Update Date:2009-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL141714200310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility