Healthcare Provider Details

I. General information

NPI: 1508851221
Provider Name (Legal Business Name): MAT NETWORK CORP.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/19/2005
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

44968 FORD RD SUITE L
CANTON MI
48187-5085
US

IV. Provider business mailing address

44968 FORD RD SUITE L
CANTON MI
48187-5085
US

V. Phone/Fax

Practice location:
  • Phone: 734-844-2100
  • Fax: 734-844-2104
Mailing address:
  • Phone: 734-844-2100
  • Fax: 734-844-2104

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number StateMI

VIII. Authorized Official

Name: SHAMILA BHATTI
Title or Position: ADMINISTRATOR
Credential:
Phone: 734-844-2100