| Entity Name: | MARTIN'S GROUP HOME, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 15 Sep 2004 (20 years ago) |
| Document Number: | P04000130078 |
| FEI/EIN Number | 421647713 |
| Address: | 12550 SW 219 ST, MIAMI, FL, 33170 |
| Mail Address: | 12550 SW 219 ST, MIAMI, FL, 33170 |
| ZIP code: | 33170 |
| County: | Miami-Dade |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1659023232 | 2022-01-25 | 2022-01-25 | 12550 SW 219TH ST, MIAMI, FL, 331702733, US | 12550 SW 219TH ST, MIAMI, FL, 331702733, US | |||||||||||||||||||||
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| Phone | +1 305-257-4108 |
| Fax | 3052574177 |
Authorized person
| Name | ALTHEA MARTIN |
| Role | DIRECTOR |
| Phone | 7863027389 |
Taxonomy
| Taxonomy Code | 320600000X - Intellectual and/or Developmental Disabilities Residential Treatment Facility |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 688682596 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| MARTIN ALTHEA | Agent | 12550 SW 219 ST, MIAMI, FL, 33170 |
| Name | Role | Address |
|---|---|---|
| MARTIN ALTHEA | President | 12550 SW 219 ST, MIAMI, FL, 33170 |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-03-07 |
| ANNUAL REPORT | 2023-03-28 |
| AMENDED ANNUAL REPORT | 2022-07-20 |
| ANNUAL REPORT | 2022-03-22 |
| ANNUAL REPORT | 2021-03-29 |
| ANNUAL REPORT | 2020-05-20 |
| ANNUAL REPORT | 2019-04-16 |
| ANNUAL REPORT | 2018-03-07 |
| ANNUAL REPORT | 2017-03-18 |
| ANNUAL REPORT | 2016-01-15 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
