Provider Demographics
NPI: | 1043984487 |
---|---|
Name: | MATTHEW 25, INC. |
Entity type: | Organization |
Organization Name: | MATTHEW 25, INC. |
Other - Org Name: | <UNAVAIL> |
Other - Org Type: | |
Authorized Official - Title/Position: | CLINICAL DIRECTOR |
Authorized Official - Prefix: | |
Authorized Official - First Name: | JONATHAN |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | ADAIR |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | MS |
Authorized Official - Phone: | 615-988-0365 |
Mailing Address - Street 1: | 625 BENTON AVE STE 120 |
Mailing Address - Street 2: | |
Mailing Address - City: | NASHVILLE |
Mailing Address - State: | TN |
Mailing Address - Zip Code: | 37204-2338 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 615-383-9577 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 625 BENTON AVE STE 120 |
Practice Address - Street 2: | |
Practice Address - City: | NASHVILLE |
Practice Address - State: | TN |
Practice Address - Zip Code: | 37204-2338 |
Practice Address - Country: | US |
Practice Address - Phone: | 615-383-9577 |
Practice Address - Fax: | |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2021-08-08 |
Last Update Date: | 2021-09-22 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 261QR0405X | Ambulatory Health Care Facilities | Clinic/Center | Rehabilitation, Substance Use Disorder | Group - Multi-Specialty |
No | 101Y00000X | Behavioral Health & Social Service Providers | Counselor | Group - Multi-Specialty | |
No | 101YA0400X | Behavioral Health & Social Service Providers | Counselor | Addiction (Substance Use Disorder) | Group - Multi-Specialty |
No | 101YM0800X | Behavioral Health & Social Service Providers | Counselor | Mental Health | Group - Multi-Specialty |
No | 104100000X | Behavioral Health & Social Service Providers | Social Worker | Group - Multi-Specialty | |
No | 106S00000X | Behavioral Health & Social Service Providers | Behavior Technician | Group - Multi-Specialty | |
No | 171000000X | Other Service Providers | Military Health Care Provider | Group - Multi-Specialty | |
No | 171M00000X | Other Service Providers | Case Manager/Care Coordinator | Group - Multi-Specialty | |
No | 174H00000X | Other Service Providers | Health Educator | Group - Multi-Specialty | |
No | 177F00000X | Other Service Providers | Lodging | ||
No | 261QM0801X | Ambulatory Health Care Facilities | Clinic/Center | Mental Health (Including Community Mental Health Center) | |
No | 261QM1300X | Ambulatory Health Care Facilities | Clinic/Center | Multi-Specialty | Group - Multi-Specialty |
No | 305R00000X | Managed Care Organizations | Preferred Provider Organization | Group - Multi-Specialty | |
No | 324500000X | Residential Treatment Facilities | Substance Abuse Rehabilitation Facility | Group - Multi-Specialty |