Provider Demographics
NPI:1235281692
Name:MAAL-CARE LLC
Entity Type:Organization
Organization Name:MAAL-CARE LLC
Other - Org Name:MAAL-CARE LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/CEO
Authorized Official - Prefix:
Authorized Official - First Name:ADDIE
Authorized Official - Middle Name:H
Authorized Official - Last Name:CARMON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:252-883-8329
Mailing Address - Street 1:2226 OTTER CREEK CHURCH RD
Mailing Address - Street 2:
Mailing Address - City:FOUNTAIN
Mailing Address - State:NC
Mailing Address - Zip Code:27829-9502
Mailing Address - Country:US
Mailing Address - Phone:252-883-8329
Mailing Address - Fax:
Practice Address - Street 1:1200 OLD FIRETOWER RD
Practice Address - Street 2:
Practice Address - City:WINTERVILLE
Practice Address - State:NC
Practice Address - Zip Code:28590-8447
Practice Address - Country:US
Practice Address - Phone:252-883-8329
Practice Address - Fax:252-756-0052
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MAAL-CARE LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-01-17
Last Update Date:2024-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251S00000X
NCMHL 074-159320600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities