Provider Demographics
NPI:1992598411
Name:MATT FAMILY RESIDENCY
Entity type:Organization
Organization Name:MATT FAMILY RESIDENCY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:FRANTZ
Authorized Official - Middle Name:R
Authorized Official - Last Name:MATHIEU
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:516-643-6233
Mailing Address - Street 1:59 ARDMOUR DR
Mailing Address - Street 2:
Mailing Address - City:MASTIC
Mailing Address - State:NY
Mailing Address - Zip Code:11950-2017
Mailing Address - Country:US
Mailing Address - Phone:516-643-6233
Mailing Address - Fax:631-657-3699
Practice Address - Street 1:59 ARDMOUR DR
Practice Address - Street 2:
Practice Address - City:MASTIC
Practice Address - State:NY
Practice Address - Zip Code:11950-2017
Practice Address - Country:US
Practice Address - Phone:516-643-6233
Practice Address - Fax:631-657-3699
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-27
Last Update Date:2025-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251J00000XAgenciesNursing Care
No251T00000XAgenciesProgram of All-Inclusive Care for the Elderly (PACE) Provider Organization
No253Z00000XAgenciesIn Home Supportive Care