Matusik Adult Family Care Home

Primary specialty

Adult Care Home FacilityTaxonomy code 311ZA0620X

License

6906460 Issued in FL

Legal business name

MATUSIK ADULT FAMILY CARE HOME

Practice address

1580 Peterson Rd
Orange City, FL 32763-8723

Phone

(386) 774-6493

NPI assigned

Feb 4, 2014

Organization subpart

No

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

Authorized official

Name

Hansrajdai Debbie Matusik

Title

Owner / Administrator

Phone

(386) 774-6493

Specialties & licenses 1

Addresses

Tax ID family

Matusik Adult Family Care Home2 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.

• Matusik Adult Family Care Home

  • Case Manager/Care Coordinator
  • Orange City, FL
  • NPI 1407283666
  NPD tax ID

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

{
    "created_epoch": "1391472000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1391472000000",
    "number": "1467876995",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1580 PETERSON RD",
            "city": "ORANGE CITY",
            "state": "FL",
            "postal_code": "327638723",
            "telephone_number": "386-774-6493"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1580 PETERSON RD",
            "city": "ORANGE CITY",
            "state": "FL",
            "postal_code": "327638723",
            "telephone_number": "386-774-6493"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MATUSIK ADULT FAMILY CARE HOME",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-02-04",
        "last_updated": "2014-02-04",
        "status": "A",
        "authorized_official_last_name": "MATUSIK",
        "authorized_official_first_name": "HANSRAJDAI",
        "authorized_official_middle_name": "DEBBIE",
        "authorized_official_title_or_position": "OWNER / ADMINISTRATOR",
        "authorized_official_telephone_number": "386-774-6493"
    },
    "taxonomies": [
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": "FL",
            "license": "6906460",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pradeep Mathur, M.D.
• Irish Matienzo
• Claudia Matos, LCSW
• Solimar Mattei-Welch, MSW, LMSW
• Matusik Adult Family Care Home
• Gabriel Kwame Mayerson, DNP
• Rabia Mazhar, MD
• Gregory E McCarthy, MD.
• Cristyl Rachelle McClure, MSN, APRN, FNP-C
• Katherine Rose McConnell, DPT

• Adult Care Home Facility in Orange City, FL
• Providers in Orange City, FL by specialty
• Adult Care Home Facility in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2014; 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.