Provider Demographics
NPI:1699317891
Name:MARTEL HEALING COMMUNITY CARE LLC
Entity type:Organization
Organization Name:MARTEL HEALING COMMUNITY CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADM
Authorized Official - Prefix:
Authorized Official - First Name:JUAN
Authorized Official - Middle Name:F
Authorized Official - Last Name:MARTEL PEREZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:817-887-9421
Mailing Address - Street 1:1425 STEVE DR
Mailing Address - Street 2:
Mailing Address - City:CROWLEY
Mailing Address - State:TX
Mailing Address - Zip Code:76036-1396
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:909 GRANBURY ST STE A
Practice Address - Street 2:
Practice Address - City:CLEBURNE
Practice Address - State:TX
Practice Address - Zip Code:76033-5711
Practice Address - Country:US
Practice Address - Phone:817-887-9421
Practice Address - Fax:817-887-9431
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-09
Last Update Date:2022-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Single Specialty
No385H00000XRespite Care FacilityRespite CareGroup - Single Specialty