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
3736 S 64TH DR, PHOENIX, AZ 85043-0127
(281) 505-0577
(833) 467-1001
Mailing address
3736 S 64TH DR, PHOENIX, AZ 85043-0127
(281) 505-0577
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
11/09/2022
Last updated
11/09/2022
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