NPIMap

Organization Active NPI

Mata Residential Care

  • Community/Behavioral Health Agency
  • Phoenix, AZ
National Provider Identifier
1821706813
Registry record updated Nov 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
MATA RESIDENTIAL CARE
Practice address
3736 S 64TH Dr
Phoenix, AZ 85043-0127
Phone
(281) 505-0577
Fax
(833) 467-1001
NPI assigned
Nov 9, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2022

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

Authorized official

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

Specialties & licenses 1

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

Addresses

Primary practice location

3736 S 64TH Dr
Phoenix, AZ 85043-0127

Mailing address

3736 S 64TH Dr
Phoenix, AZ 85043-0127
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": "1667952000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1667952000000",
    "number": "1821706813",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3736 S 64TH DR",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850430127",
            "telephone_number": "281-505-0577"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3736 S 64TH DR",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850430127",
            "telephone_number": "281-505-0577",
            "fax_number": "833-467-1001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MATA RESIDENTIAL CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-11-09",
        "last_updated": "2022-11-09",
        "certification_date": "2022-11-06",
        "status": "A",
        "authorized_official_last_name": "MATABARO",
        "authorized_official_first_name": "JEAN CLAUDE",
        "authorized_official_title_or_position": "PROGRAM DIRECTOR",
        "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 Nov 9, 2022; 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.