JAMITA MARTIN (NPI# 1366807778) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366807778 |
| Entity Type | Individual |
| Full Name | JAMITA MARTIN |
| Practice Address |
6468 Hwy 92 Suite 140 Acworth GA 30102-0005 |
| Mailing Address |
Po Box 2298 Acworth GA 30102-0005 |
| Practice Telephone | 7706349994 |
| Practice Fax Number | 8554136890 |
| Mailing Telephone | 7706349994 |
| Mailing Fax Number | 8554136890 |
| Enumeration Date | 2015-12-30 |
| Last Update Date | 2015-12-30 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 320900000X | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | LC20150000857 | GA | Residential Treatment Facilities |
| Street Address |
6468 HWY 92 SUITE 140 |
| City | ACWORTH |
| State | GA |
| Zip Code | 30102-0005 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821563677 | Amanda Kristine Roberts | Specialist/Technologist | 1493 Highway 92, Acworth, GA 30102 | 2018-10-09 |
| 1265958391 | Hannah Pepper | Doula | 115 Bennett Farms Dr, Acworth, GA 30102 | 2017-08-21 |
| 1528594314 | Kendra Chantelle Krieg | Emergency Medicine | 185 Anniversary Ln, Acworth, GA 30102 | 2017-05-11 |
| 1215484860 | Jackson Family Therapy and Counseling | Community/Behavioral Health | 2117 Hamby Cove Dr, Nw, Acworth, GA 30102 | 2016-09-01 |
| 1295089134 | The Hopequest Ministry Group, Inc. | Substance Abuse Rehabilitation Facility | 5345 Crossroads Drive, Acworth, GA 30102 | 2012-10-30 |
| 1851609887 | Health Cord of Georgia Inc | Emergency Medical Technician, Basic | 5345 Bells Ferry Rd, Acworth, GA 30102 | 2010-09-24 |
| 1073842928 | Susan Rachel Layton | Clinical Nurse Specialist | 519 Olympic Way, Acworth, GA 30102 | 2009-12-23 |
| 1073779971 | Karen Casadaban | Speech-Language Pathologist | 4957 Day Lily Way, Acworth, GA 30102 | 2008-07-31 |
| 1538205109 | Alan Stuart Horlick | Dentist | 6572 Highway 92, Suite 120, Acworth, GA 30102 | 2007-01-30 |
| 1982620472 | Samuel Arthur Mielcarski | Physical Therapist | 5505 Bells Ferry Rd, Suite 240, Acworth, GA 30102 | 2006-07-15 |
| Find all providers in zip 30102 | ||||
| Taxonomy Code | 320900000X |
| Grouping | Residential Treatment Facilities |
| Classification | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities |
| A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with mental retardation and/or developmental disabilities. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790385862 | Hickory Log Vocational School Inc | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 3680 Highway 411 Ne, White, GA 30184-2427 | 2020-10-28 |
| 1801403050 | Safe Haven Personal Care Home | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 10875 Abercorn St Apt 132, Savannah, GA 31419-1843 | 2020-09-30 |
| 1659987931 | Pinkies Place | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 216 Self St, Warner Robins, GA 31088-5506 | 2020-09-22 |
| 1629680293 | Caregiver Ga, LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 3736 Executive Center Dr Ste B, Augusta, GA 30907-2360 | 2020-08-17 |
| 1730799073 | Victory Won Counseling and Res Care Prof. Corp | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 5014 Snapfinger Woods Dr, Decatur, GA 30035-4003 | 2020-08-02 |
| 1811528649 | Unison Behavioral Health | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 211 North Street, Douglas, GA 31533 | 2020-01-30 |
| 1619519709 | Gateway Behavioral Health Services | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 516 Freedom Trl, Brunswick, GA 31525-4712 | 2019-10-10 |
| 1215581756 | Elegant Lm Management, LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1020 Meadowsong Circle, Lawrenceville, GA 30043 | 2019-08-01 |
| 1467013821 | Csb of East Central Ga | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 5101 Parnell Way, Martinez, GA 30907-8896 | 2019-06-26 |
| 1013474915 | Community Service Board of East Central Georgia | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1715 Lawerence Rd, Hephzibah, GA 30815-4445 | 2019-02-27 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.