# MATTIE'S CARE HOUSE, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1467292086
- **Authorized official:** LATOYA JANELLE LEE CAO/PA (CEO)
- **Authorized official phone:** (602) 686-0419

## Contact information

- **Practice address:** 8015 S 23RD DR, PHOENIX, AZ 85041-7650
- **Practice address phone:** (602) 686-0419
- **Mailing address:** 6823 W PLEASANT LN, LAVEEN, AZ 85339-2660
- **Mailing address phone:** (602) 686-0419
- **Mailing address fax:** (602) 585-9302

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 320600000X | Intellectual and/or Developmental Disabilities Residential Treatment Facility | — | NULL | Yes |

## Other

- **Enumeration date:** 05/30/2024
- **Last updated:** 05/30/2024