| Mata Residential Care | |
|
6333 W Raymond St Phoenix AZ 85043-0135 | |
| (281) 505-0577 | |
| (833) 467-1001 |
| Full Name | Mata Residential Care |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 6333 W Raymond St, Phoenix, Arizona |
| Authorized Official Name and Position | Jean Claude Matabaro (PROGRAM DIRECTOR) |
| Authorized Official Contact | 2815050577 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mata Residential Care 6333 W Raymond St Phoenix AZ 85043-0135 Ph: (281) 505-0577 | Mata Residential Care 6333 W Raymond St Phoenix AZ 85043-0135 Ph: (281) 505-0577 |
| NPI Number | 1548978539 |
|---|---|
| Provider Enumeration Date | 11/09/2022 |
| Last Update Date | 11/09/2022 |
| Certification Date | 11/06/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1548978539 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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