Provider Demographics
NPI:1407131097
Name:GLOBAL MATRIX INTERNATIONAL INC.
Entity Type:Organization
Organization Name:GLOBAL MATRIX INTERNATIONAL INC.
Other - Org Name:GLOBAL IMPACT SOLUTIONS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:MARIO
Authorized Official - Middle Name:LANCASTER
Authorized Official - Last Name:KIMBALL
Authorized Official - Suffix:
Authorized Official - Credentials:M-DIV
Authorized Official - Phone:678-596-0320
Mailing Address - Street 1:6030 HIGHWAY 85 STE 202-4
Mailing Address - Street 2:
Mailing Address - City:RIVERDALE
Mailing Address - State:GA
Mailing Address - Zip Code:30274-1529
Mailing Address - Country:US
Mailing Address - Phone:678-596-0320
Mailing Address - Fax:
Practice Address - Street 1:6030 HWY 85 STE 202-4
Practice Address - Street 2:
Practice Address - City:RIVERDALE
Practice Address - State:GA
Practice Address - Zip Code:30274
Practice Address - Country:US
Practice Address - Phone:678-596-0320
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-15
Last Update Date:2011-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health