NPIMap

Organization Active NPI

Mata Residential Care LLC

  • Developmental Disabilities Clinic/Center
  • Glendale, AZ
National Provider Identifier
1952095036
Registry record updated Jun 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Developmental Disabilities Clinic/CenterTaxonomy code 261QD1600X
Legal business name
MATA RESIDENTIAL CARE LLC
Practice address
8805 W Glenn Dr
Glendale, AZ 85305-6903
Phone
(207) 408-2792
NPI assigned
Jun 2, 2023
Organization subpart
Yes
Parent organization
MATA RESIDENTIAL CARE LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 2, 2023

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

Authorized official

Name
Sonia U Ntare
Title
Ceo
Phone
(207) 408-2792

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Developmental Disabilities Clinic/Center 261QD1600X Primary

Addresses

Primary practice location

8805 W Glenn Dr
Glendale, AZ 85305-6903

Mailing address

8805 W Glenn Dr
Glendale, AZ 85305-6903
Phone (207) 408-2792

National Provider Directory

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

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": "1685664000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1685664000000",
    "number": "1952095036",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8805 W GLENN DR",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853056903",
            "telephone_number": "207-408-2792"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8805 W GLENN DR",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853056903",
            "telephone_number": "207-408-2792"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MATA RESIDENTIAL CARE LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MATA RESIDENTIAL CARE LLC",
        "enumeration_date": "2023-06-02",
        "last_updated": "2023-06-02",
        "certification_date": "2023-05-22",
        "status": "A",
        "authorized_official_last_name": "NTARE",
        "authorized_official_first_name": "SONIA",
        "authorized_official_middle_name": "U",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "207-408-2792"
    },
    "taxonomies": [
        {
            "code": "261QD1600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 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.