Provider Demographics
NPI:1487778312
Name:MARTINS' ACHIEVEMENT PLACE, INC.
Entity type:Organization
Organization Name:MARTINS' ACHIEVEMENT PLACE, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:QUALITY ASSURANCE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:K
Authorized Official - Last Name:THOMPSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:916-967-6253
Mailing Address - Street 1:7806 UPLANDS WAY, SUITE C
Mailing Address - Street 2:
Mailing Address - City:CITRUS HEIGHTS
Mailing Address - State:CA
Mailing Address - Zip Code:95610
Mailing Address - Country:US
Mailing Address - Phone:916-967-6253
Mailing Address - Fax:916-967-9413
Practice Address - Street 1:7806 UPLANDS WAY, SUITE C
Practice Address - Street 2:
Practice Address - City:CITRUS HEIGHTS
Practice Address - State:CA
Practice Address - Zip Code:95610
Practice Address - Country:US
Practice Address - Phone:916-967-6253
Practice Address - Fax:916-967-9413
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MARTINS' ACHIEVEMENT PLACE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-03-17
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
320600000X, 322D00000X
CA322D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes322D00000XResidential Treatment FacilitiesResidential Treatment Facility, Emotionally Disturbed Children
No320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities