Healthcare Provider Details

I. General information

NPI: 1831459288
Provider Name (Legal Business Name): MAED LIFE AND HEALTH SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/19/2012
Last Update Date: 05/19/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6301 IVY LN SUITE 700
GREENBELT MD
20770-1402
US

IV. Provider business mailing address

6301 IVY LN SUITE 700
GREENBELT MD
20770-1402
US

V. Phone/Fax

Practice location:
  • Phone: 301-220-0029
  • Fax: 301-560-8058
Mailing address:
  • Phone: 301-220-0029
  • Fax: 301-560-8058

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State

VIII. Authorized Official

Name: MR. EDWARD CHARMANY MOKAM
Title or Position: PRESIDENT
Credential:
Phone: 301-592-7112