Provider Demographics
NPI:1710516885
Name:SARA MATOS
Entity Type:Organization
Organization Name:SARA MATOS
Other - Org Name:1ST CHOICE COMPREHENSIVE CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SARA
Authorized Official - Middle Name:
Authorized Official - Last Name:MATOS
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:347-721-1527
Mailing Address - Street 1:1830 W TRADE LN
Mailing Address - Street 2:
Mailing Address - City:CITRUS SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:34434-5525
Mailing Address - Country:US
Mailing Address - Phone:347-721-1527
Mailing Address - Fax:
Practice Address - Street 1:1830 W TRADE LN
Practice Address - Street 2:
Practice Address - City:CITRUS SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:34434-5525
Practice Address - Country:US
Practice Address - Phone:347-721-1527
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-02
Last Update Date:2022-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
No251S00000XAgenciesCommunity/Behavioral HealthGroup - Single Specialty