Healthcare Provider Details

I. General information

NPI: 1326938531
Provider Name (Legal Business Name): MARZETTE'S HOUSE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/08/2025
Last Update Date: 07/08/2025
Certification Date: 07/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1609 E PALMDALE BLVD STE D
PALMDALE CA
93550-4881
US

IV. Provider business mailing address

37535 ARBOR LN
PALMDALE CA
93552-4504
US

V. Phone/Fax

Practice location:
  • Phone: 661-728-6405
  • Fax:
Mailing address:
  • Phone: 661-728-6405
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251V00000X
TaxonomyVoluntary or Charitable Agency
License Number
License Number State

VIII. Authorized Official

Name: MS. MARGARET HICKS
Title or Position: COO
Credential:
Phone: 661-728-6405