Marthalene Logan
Marthalene Logan is registered under Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Bethlehem, Georgia. Practices as a sole proprietor. Registered with an NPI since 2014.
- In the registry since
- 2014
Practice location Address checks out
4514 Yorktown DrBethlehem, GA 30620-4826 Not confirmed with CMS for 12 years — call before visiting
Phone: (678) 635-5463
Show map & directions
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility (primary) | Taxonomy 320900000X |
|---|
Record details
| NPI number | 1700289048 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Female |
| Sole proprietor | Yes |
| NPI enumerated | October 1, 2014 |
| Last updated in NPPES | October 1, 2014 |
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