Mattie'S Care House, LLC

Primary specialty

Intellectual and/or Developmental Disabilities Residential Treatment FacilityTaxonomy code 320600000X

Legal business name

MATTIE'S CARE HOUSE, LLC

Practice address

8015 S 23Rd Dr
Phoenix, AZ 85041-7650

Phone

(602) 686-0419

NPI assigned

May 30, 2024

Organization subpart

No

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

Authorized official

Name

Latoya Janelle Lee, CAO/PA

Title

Ceo

Phone

(602) 686-0419

Specialties & licenses 1

Addresses

Tax ID family

Mattie'S Care House LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Mattie'S Care House, LLC

  • Mental Illness Community Based Residential Treatment Facility
  • Laveen, AZ
  • NPI 1447601448
  NPD tax ID

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

{
    "created_epoch": "1717027200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1717027200000",
    "number": "1467292086",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6823 W PLEASANT LN",
            "city": "LAVEEN",
            "state": "AZ",
            "postal_code": "853392660",
            "telephone_number": "602-686-0419",
            "fax_number": "602-585-9302"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8015 S 23RD DR",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850417650",
            "telephone_number": "602-686-0419"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MATTIE'S CARE HOUSE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-05-30",
        "last_updated": "2024-05-30",
        "certification_date": "2024-05-30",
        "status": "A",
        "authorized_official_last_name": "LEE",
        "authorized_official_first_name": "LATOYA",
        "authorized_official_middle_name": "JANELLE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "602-686-0419",
        "authorized_official_credential": "CAO/PA"
    },
    "taxonomies": [
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rasha Matti
• Donald Mattia
• Rylee Mattice, BCBA
• Spencer Mattice
• Trenton Chase Mattice, PHARMD
• Audrey Bernadette Mattimore, MS, RD
• Ashley Broek Mattix, FNP
• Cheryl R Mattke, RN
• Sierra Mattos
• Kim Mattson

• Intellectual and/or Developmental Disabilities Residential Treatment Facility in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Intellectual and/or Developmental Disabilities Residential Treatment Facility in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2024; 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.