Provider Demographics
NPI:1134759244
Name:MATREAD CARE, LLC
Entity type:Organization
Organization Name:MATREAD CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JULIET
Authorized Official - Middle Name:C
Authorized Official - Last Name:KESHINRO
Authorized Official - Suffix:
Authorized Official - Credentials:PROVIDER
Authorized Official - Phone:302-669-5402
Mailing Address - Street 1:2777 S ARIZONA AVE APT 1095
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85286-1805
Mailing Address - Country:US
Mailing Address - Phone:302-669-5402
Mailing Address - Fax:
Practice Address - Street 1:64 E BROADWAY RD STE 200
Practice Address - Street 2:
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85282-1377
Practice Address - Country:US
Practice Address - Phone:480-525-3405
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-17
Last Update Date:2020-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health