Organization
MATA RESIDENTIAL CARE LLC
Active
Parent organization
MATA RESIDENTIAL CARE LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
MATA RESIDENTIAL CARE LLC
Authorized official
SONIA U NTARE (CEO)
(207) 408-2792
Entity
Organization
Contact information
Practice address
8805 W GLENN DR, GLENDALE, AZ 85305-6903
(207) 408-2792
Mailing address
8805 W GLENN DR, GLENDALE, AZ 85305-6903
(207) 408-2792
Taxonomy
Speciality
Code
Description
License number
State
261QD1600X
Developmental Disabilities Clinic/Center
Primary
—
—
Other
Enumeration date
06/02/2023
Last updated
06/02/2023
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