Provider Demographics
NPI:1508851221
Name:MAT NETWORK CORP.
Entity Type:Organization
Organization Name:MAT NETWORK CORP.
Other - Org Name:LIFE TOUCH HOMECARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:SHAMILA
Authorized Official - Middle Name:
Authorized Official - Last Name:BHATTI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:734-844-2100
Mailing Address - Street 1:44968 FORD RD
Mailing Address - Street 2:SUITE L
Mailing Address - City:CANTON
Mailing Address - State:MI
Mailing Address - Zip Code:48187-5085
Mailing Address - Country:US
Mailing Address - Phone:734-844-2100
Mailing Address - Fax:734-844-2104
Practice Address - Street 1:44968 FORD RD
Practice Address - Street 2:SUITE L
Practice Address - City:CANTON
Practice Address - State:MI
Practice Address - Zip Code:48187-5085
Practice Address - Country:US
Practice Address - Phone:734-844-2100
Practice Address - Fax:734-844-2104
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-19
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4654100Medicaid
MI237500Medicare Oscar/Certification