Provider Demographics
NPI:1619587490
Name:MAAT THERAPEUTIC SOLUTIONS INC.
Entity Type:Organization
Organization Name:MAAT THERAPEUTIC SOLUTIONS INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOCIAL WORKER / CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:WALTER
Authorized Official - Middle Name:RANDOLPH
Authorized Official - Last Name:HOWELL
Authorized Official - Suffix:JR
Authorized Official - Credentials:LICSW
Authorized Official - Phone:617-835-7750
Mailing Address - Street 1:1773 DORCHESTER AVE STE 3
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02124-2556
Mailing Address - Country:US
Mailing Address - Phone:617-835-7750
Mailing Address - Fax:
Practice Address - Street 1:1773 DORCHESTER AVE STE 3
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02124-2556
Practice Address - Country:US
Practice Address - Phone:617-835-7750
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-05
Last Update Date:2020-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA110116980AMedicaid