Provider Demographics
NPI:1417653015
Name:SLYMATT, LLC
Entity Type:Organization
Organization Name:SLYMATT, LLC
Other - Org Name:CORA HEALTHCARE SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:SYLVESTER
Authorized Official - Middle Name:
Authorized Official - Last Name:HAGAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:571-357-9158
Mailing Address - Street 1:16931 TOMS RIVER LOOP
Mailing Address - Street 2:
Mailing Address - City:DUMFRIES
Mailing Address - State:VA
Mailing Address - Zip Code:22026-2178
Mailing Address - Country:US
Mailing Address - Phone:571-357-9158
Mailing Address - Fax:
Practice Address - Street 1:16931 TOMS RIVER LOOP
Practice Address - Street 2:
Practice Address - City:DUMFRIES
Practice Address - State:VA
Practice Address - Zip Code:22026-2178
Practice Address - Country:US
Practice Address - Phone:571-357-9158
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SLYMATT, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-02-06
Last Update Date:2023-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health