MEDICARE: MARTINS' ACHIEVEMENT PLACE, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number State
1	320600000X	Intellectual and/or Developmental Disabilities Residential Treatment Facility
2	322D00000X	Emotionally Disturbed Childrens' Residential Treatment Facility
3	322D00000X	Emotionally Disturbed Childrens' Residential Treatment Facility	CA

General Provider Information

NPI Number	:	1487778312
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MARTINS' ACHIEVEMENT PLACE, INC.

Provider Business Mailing Address
First Line	:	7806 UPLANDS WAY, SUITE C
Second Line	:
City	:	CITRUS HEIGHTS
State	:	CA
Zip	:	95610
Country	:	US
Telephone Number	:	916-967-6253
Fax Number	:	916-967-9413

Provider Business Practice Location Address
First Line	:	7806 UPLANDS WAY, SUITE C
Second Line	:
City	:	CITRUS HEIGHTS
State	:	CA
Zip	:	95610
Country	:	US
Telephone Number	:	916-967-6253
Fax Number	:	916-967-9413

Authorized Official
Title or Position	:	QUALITY ASSURANCE DIRECTOR
Name	:	JENNIFER K THOMPSON
Credential	:
Telephone Number	:	916-967-6253

Provider Enumeration Date	:	03/17/2007
Last Update Date	:	07/21/2022

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Directions to “MARTINS' ACHIEVEMENT PLACE, INC. ” Practice Location

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