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General NPI Number Information
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NPI Number | 1730789025
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Entity Type | Organization
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Legal Business Name | MAT CARE CLINICS LLC
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Dates
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Enumeration Date | 10/27/2020
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Last Update Date | 06/19/2023
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Provider Practice Location Address
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Address Line | 155 MAIN DUNSTABLE RD STE 210
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City | NASHUA
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State | NH
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Zip | 03060-3640
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Country | US
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Telephone | 833-622-0628
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Fax | 603-417-5937
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Provider Business Mailing Address
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Address Line | 155 MAIN DUNSTABLE RD STE 200
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City | NASHUA
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State | NH
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Zip | 03060-3640
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Country | US
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Telephone | 603-821-0056
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Fax | 603-417-5937
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Authorized Official
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Title or Position | CHIEF FINANCIAL OFFICER
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Name | RUSTY TAYLOR
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Credential |
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Telephone | 561-917-2993
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 163WP0809X
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Taxonomy Name | Adult Psychiatric/Mental Health Registered Nurse
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #8
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Taxonomy Code | 2083A0300X
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Taxonomy Name | Addiction Medicine (Preventive Medicine) Physician
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License Number |
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License Number State |
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