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General NPI Number Information
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NPI Number | 1134759244
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Entity Type | Organization
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Legal Business Name | MATREAD CARE, LLC
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Dates
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Enumeration Date | 01/17/2020
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Last Update Date | 02/12/2020
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Provider Practice Location Address
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Address Line | 64 E BROADWAY RD STE 200
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City | TEMPE
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State | AZ
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Zip | 85282-1377
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Country | US
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Telephone | 480-525-3405
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Fax |
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Provider Business Mailing Address
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Address Line | 2777 S ARIZONA AVE APT 1095
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City | CHANDLER
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State | AZ
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Zip | 85286-1805
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Country | US
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Telephone | 302-669-5402
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | JULIET C KESHINRO
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Credential | PROVIDER
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Telephone | 302-669-5402
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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