MARTHALENE LOGAN (NPI# 1700289048) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1700289048 |
| Entity Type | Individual |
| Full Name | MARTHALENE LOGAN |
| Practice Address |
4514 Yorktown Dr Bethlehem GA 30620-4826 |
| Mailing Address |
250 North Ave Athens GA 30601-2244 |
| Practice Telephone | 6786355463 |
| Mailing Telephone | 7063896790 |
| Mailing Fax Number | 7063896760 |
| Enumeration Date | 2014-10-01 |
| Last Update Date | 2014-10-01 |
| 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 | Residential Treatment Facilities |
| Street Address |
4514 YORKTOWN DR |
| City | BETHLEHEM |
| State | GA |
| Zip Code | 30620-4826 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730747528 | Georgia Dental Professionals, PC | Dentist | 920 Loganville Hwy Ste 100, Bethlehem, GA 30620 | 2019-06-05 |
| 1518445683 | Bethlehem Dentistry, LLC | Dentist | 255 Gateway Drive, Suite 200, Bethlehem, GA 30620 | 2018-08-01 |
| 1881621233 | Manan I Shah | Ophthalmology | 14 Vision Street, Suite 100, Bethlehem, GA 30620 | 2006-06-28 |
| 1871088997 | Stephanie Grace Bair | Occupational Therapist | 916 Loganville Hwy Ste 1130, Bethlehem, GA 30620 | 2018-06-30 |
| 1588159958 | John David Williams | Physical Therapist | 916 Loganville Hwy Ste 1130, Bethlehem, GA 30620 | 2018-06-27 |
| 1023460938 | Virginia Persons Labella | Nurse Practitioner | 340 Exchange Blvd Ste 130, Bethlehem, GA 30620 | 2016-07-05 |
| 1649656356 | Kimberly Christine Thomas | Physical Therapist | 916 Loganville Hwy Ste 1130, Bethlehem, GA 30620 | 2015-08-04 |
| 1336468131 | Manan I Shah Md PC | Ophthalmology | 14 Vision Street, Suite 100, Bethlehem, GA 30620 | 2010-05-19 |
| 1265998454 | Dawn Crook | Community/Behavioral Health | 509 Harry Mccarty Rd, Bethlehem, GA 30620-1707 | 2019-02-13 |
| 1447667233 | Susan Hardy Leighty | Nurse Practitioner | 340 Exchange Blvd Ste 130, Bethlehem, GA 30620-1759 | 2014-07-14 |
| Find all providers in zip 30620 | ||||
| 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 |
|---|---|---|---|---|
| 1164767182 | Carmela Smith Gray Host Home | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 149 Thorn Brook Rd, Bethlehem, GA 30620-2405 | 2012-12-03 |
| 1245581461 | Spectrum Social Services, Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1655 Valley Center Pkwy, St 150, Bethlehem, PA 18017-2347 | 2012-09-27 |
| 1427261577 | Resources for Human Development | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 4544 Bath Pike, Bethlehem, PA 18017 | 2007-05-07 |
| 1801925540 | Resources for Human Development | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 4925 Wagner Dr, Bethlehem, PA 18020-8816 | 2007-03-05 |
| 1750410668 | Resources for Human Development | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 4967 Hanoverville Rd, Bethlehem, PA 18020-9409 | 2007-03-05 |
| 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.