Healthcare Provider Details
I. General information
NPI: 1184588303
Provider Name (Legal Business Name): MARTIS LEGACY HOLDINGS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 12/11/2025
Last Update Date: 12/11/2025
Certification Date: 12/11/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
27735 DREAM FALLS DR APT 110
WESLEY CHAPEL FL
33544-5360
US
IV. Provider business mailing address
27735 DREAM FALLS DR APT 110
WESLEY CHAPEL FL
33544-5360
US
V. Phone/Fax
- Phone: 618-925-2599
- Fax:
- Phone: 618-925-2599
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 251E00000X |
| Taxonomy | Home Health Agency |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
LAURA
JO
YOBA
Title or Position: CEO/OWNER
Credential:
Phone: 618-925-2599