Organization
MATA RESIDENTIAL CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEAN CLAUDE MATABARO (PROGRAM DIRECTOR)
(281) 505-0577
Entity
Organization
Contact information
Practice address
9240 W MINNEZONA AVE, PHOENIX, AZ 85037-2447
(281) 505-0577
Mailing address
9240 W MINNEZONA AVE, PHOENIX, AZ 85037-2447
(281) 505-0577
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
07/26/2021
Last updated
07/26/2021
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