Madiata, Chantal
Madiata, Chantal is an sole proprietor health care provider with primary practice located at 3641 W Bellewood Pl , Tucson AZ 85741-5407. She recently has 2 registered licenses in different health care specialties including Respite Care Facility / Respite Care, Other Service Providers / Contractor. Respite Care Facility / Respite Care is her primary health care specialty. Madiata, Chantal can be contacted via phone (520) 351-9952.Contact Information
Primary practice address
3641 W Bellewood Pl
Tucson AZ 85741-5407
Phone: (520) 351-9952
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Respite Care Facility / Respite Care | 385H00000X | BH5270 | Arizona |
| Other Service Providers / Contractor | 171W00000X | BH4643 | Arizona |
Profile Details
| NPI number | 1679954549 |
|---|---|
| LBN Legal business name | Madiata, Chantal |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jun 16th, 2015 |
| Last updated | Sep 4th, 2020 - about 4 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1679954549 | NPPES |
| Arizona | Other | BH5270 | AZ DEPT OF HEALTH SERVICES |
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