Organization
AMATALLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MASON MATTHEW TERRY (OFFICE MANAGER)
(909) 379-9237
Entity
Organization
Contact information
Practice address
222 W 6TH ST, CORONA, CA 92882-3301
(909) 379-9237
(888) 507-7087
Mailing address
222 W 6TH ST, CORONA, CA 92882-3301
(909) 379-9237
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
—
—
261QM2800X
Methadone Clinic
Primary
—
—
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
—
—
276400000X
Substance Use Disorder Rehabilitation Hospital Unit
—
—
Other
Enumeration date
09/08/2022
Last updated
09/20/2022
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