Organization
ISHOLA EMPIRE INCORPORATED
Active
Other names
ST. MATTHEWS CLINIC
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MYISHOLA MATTHEWS (DIRECTOR)
(850) 736-0779
Entity
Organization
Contact information
Practice address
118 AMARYLISS AVE, ORANGE, TX 77630-4602
(850) 736-0779
Mailing address
118 AMARYLISS AVE, ORANGE, TX 77630-4602
(720) 663-0265
Taxonomy
Speciality
Code
Description
License number
State
101YP1600X
Pastoral Counselor
—
—
251B00000X
Case Management Agency
—
—
251S00000X
Community/Behavioral Health Agency
—
—
251V00000X
Voluntary or Charitable Agency
—
—
261Q00000X
Clinic/Center
Primary
—
—
302R00000X
Health Maintenance Organization
—
—
Other
Enumeration date
05/04/2023
Last updated
05/26/2023
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