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Erica Nicole Martin
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Jackson, Tennessee
NPI 1174305007

Erica Nicole Martin is a Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility based in Jackson, TN. Erica Nicole Martin practices in Jackson, TN. The NPI Number for Erica Nicole Martin is 1174305007 and holds a License No. I000000022582 (Tennessee).

The current practice location address for Erica Nicole Martin is 364 N Parkway Ste 8, Jackson, TN and can be reached out via phone at 731-431-7241 and via fax at 731-736-1111.

Location: 364 N Parkway Ste 8, Jackson, TN, 38305-2874
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1174305007
Provider Name
Erica Nicole Martin
Credential
Provider Entity Type
Individual
Gender
Female
Address
364 N Parkway Ste 8, Jackson, TN, 38305-2874
Phone Number
731-431-7241
Fax Number
731-736-1111
Provider Enumeration Date
10/16/2023
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
364 N Parkway Ste 8
City
Jackson
State
Tennessee
Zip
38305-2874
Phone Number
731-431-7241
Fax Number
731-736-1111
person
Provider Business Mailing Address Details
Address
364 N Parkway Ste 8
City
Jackson
State
Tennessee
Zip
38305-2874
Phone Number
731-431-7241
Fax Number
731-736-1111
person
Provider's Taxonomy Details 1
Type
Residential Treatment Facilities
Classification
Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Speciality
-
Taxonomy
320900000X
License No.
I000000022582 (Tennessee)
Definition
A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with intellectual and/or developmental disabilities.
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