Mattmo Outreach Residential Serivces

Primary specialty

Assisted Living Facility (Mental Illness)Taxonomy code 3104A0625X

Legal business name

MATTMO OUTREACH RESIDENTIAL SERIVCES

Practice address

135 S Liberty St
Delaware, OH 43015-2568

Phone

(804) 912-4095

NPI assigned

Oct 4, 2016

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Miss Hajah Memunatu Conteh, BSN, RN

Title

Director

Phone

(804) 912-4095

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1475539200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1475539200000",
    "number": "1104375013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "135 S LIBERTY ST",
            "city": "DELAWARE",
            "state": "OH",
            "postal_code": "430152568",
            "telephone_number": "804-912-4095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "135 S LIBERTY ST",
            "city": "DELAWARE",
            "state": "OH",
            "postal_code": "430152568",
            "telephone_number": "804-912-4095"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MATTMO OUTREACH RESIDENTIAL SERIVCES",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-04",
        "last_updated": "2016-10-04",
        "status": "A",
        "authorized_official_last_name": "CONTEH",
        "authorized_official_first_name": "HAJAH",
        "authorized_official_middle_name": "MEMUNATU",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "804-912-4095",
        "authorized_official_name_prefix": "Miss",
        "authorized_official_credential": "BSN, RN"
    },
    "taxonomies": [
        {
            "code": "3104A0625X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility, Assisted Living, Mental Illness",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Maryhaven Inc
• Natalie Taylor Massa Wallace, DDS
• Ashley M Matchack, LPN
• Amy Mattern, D.O.
• John Roger Matthews II, PEER SPECIALIST
• Teresa Marie Matzke, FNP
• Rebecca Mauer
• Karen Ruth Mayer, RN, LPCC
• Kathleen Maynard
• Michael Mayo

• Assisted Living Facility (Mental Illness) in Delaware, OH
• Providers in Delaware, OH by specialty
• Assisted Living Facility (Mental Illness) in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.