Provider Demographics
NPI:1598998734
Name:MURRAY ADOLESCENT TRAINING & TREATMENT ACADEMY, INC
Entity Type:Organization
Organization Name:MURRAY ADOLESCENT TRAINING & TREATMENT ACADEMY, INC
Other - Org Name:MATTA, INC.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:ISAAC
Authorized Official - Middle Name:L
Authorized Official - Last Name:MURRAY
Authorized Official - Suffix:
Authorized Official - Credentials:MED
Authorized Official - Phone:704-372-4915
Mailing Address - Street 1:2012 COMMONWEALTH AVE
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28205-5022
Mailing Address - Country:US
Mailing Address - Phone:704-372-4915
Mailing Address - Fax:704-372-4915
Practice Address - Street 1:2012 COMMONWEALTH AVE
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28205-5022
Practice Address - Country:US
Practice Address - Phone:704-372-4915
Practice Address - Fax:704-372-4915
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-03
Last Update Date:2009-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care