NPIMap

Organization Active NPI

Mata Residential Care

  • Community/Behavioral Health Agency
  • Phoenix, AZ
National Provider Identifier
1235868399
Registry record updated Aug 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
MATA RESIDENTIAL CARE
Practice address
3813 S 65TH Ave
Phoenix, AZ 85043-0133
Phone
(281) 505-0577
Fax
(833) 467-1001
NPI assigned
Jun 6, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2023

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

Authorized official

Name
Jean Claude Matabaro
Title
Program Manager
Phone
(281) 505-0577

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X Primary

Addresses

Primary practice location

3813 S 65TH Ave
Phoenix, AZ 85043-0133

Mailing address

3813 S 65TH Ave
Phoenix, AZ 85043-0133
Phone (281) 505-0577

National Provider Directory

National Provider Directory
Tax ID family
Mata Residential Care7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1654473600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1691798400000",
    "number": "1235868399",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3813 S 65TH AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850430133",
            "telephone_number": "281-505-0577",
            "fax_number": "833-467-1001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3813 S 65TH AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850430133",
            "telephone_number": "281-505-0577",
            "fax_number": "833-467-1001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MATA RESIDENTIAL CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-06-06",
        "last_updated": "2023-08-12",
        "certification_date": "2023-08-12",
        "status": "A",
        "authorized_official_last_name": "MATABARO",
        "authorized_official_first_name": "JEAN CLAUDE",
        "authorized_official_title_or_position": "PROGRAM MANAGER",
        "authorized_official_telephone_number": "281-505-0577"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2023; 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.