Provider Demographics
NPI:1083884332
Name:MATRIX EVALUATION AND COUNSELING SERVICES LLC
Entity Type:Organization
Organization Name:MATRIX EVALUATION AND COUNSELING SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:
Authorized Official - Last Name:HARRIS
Authorized Official - Suffix:
Authorized Official - Credentials:CACII, CAMS, MBA
Authorized Official - Phone:770-364-1074
Mailing Address - Street 1:3100 RIVER EXCHANGE DR
Mailing Address - Street 2:828
Mailing Address - City:NORCROSS
Mailing Address - State:GA
Mailing Address - Zip Code:30092-4224
Mailing Address - Country:US
Mailing Address - Phone:770-364-1074
Mailing Address - Fax:770-209-4188
Practice Address - Street 1:3100 RIVER EXCHANGE DR
Practice Address - Street 2:828
Practice Address - City:NORCROSS
Practice Address - State:GA
Practice Address - Zip Code:30092-4224
Practice Address - Country:US
Practice Address - Phone:770-364-1074
Practice Address - Fax:770-209-4188
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-03
Last Update Date:2008-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
No251S00000XAgenciesCommunity/Behavioral Health