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General NPI Number Information
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NPI Number | 1346528783
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Entity Type | Organization
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Legal Business Name | MATHEWS' HOMES, INC.
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Dates
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Enumeration Date | 08/03/2011
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Last Update Date | 08/03/2011
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Provider Practice Location Address
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Address Line | 19500 MIDDLEBELT RD SUITE 225E
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City | LIVONIA
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State | MI
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Zip | 48152-2196
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Country | US
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Telephone | 248-987-2500
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Fax | 248-987-2502
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Provider Business Mailing Address
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Address Line | 19500 MIDDLEBELT RD SUITE 225E
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City | LIVONIA
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State | MI
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Zip | 48152-2196
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Country | US
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Telephone | 248-987-2500
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Fax | 248-987-2502
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. LAMAR ANTHONY MATHEWS SR.
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Credential |
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Telephone | 248-987-2500
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 320800000X
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Taxonomy Name | Mental Illness Community Based Residential Treatment Facility
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License Number | AS820071488
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License Number State | MI
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