Provider Demographics
NPI:1831459288
Name:MAED LIFE AND HEALTH SERVICES LLC
Entity Type:Organization
Organization Name:MAED LIFE AND HEALTH SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:CHARMANY
Authorized Official - Last Name:MOKAM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-592-7112
Mailing Address - Street 1:6301 IVY LN
Mailing Address - Street 2:SUITE 700
Mailing Address - City:GREENBELT
Mailing Address - State:MD
Mailing Address - Zip Code:20770-1402
Mailing Address - Country:US
Mailing Address - Phone:301-220-0029
Mailing Address - Fax:301-560-8058
Practice Address - Street 1:6301 IVY LN
Practice Address - Street 2:SUITE 700
Practice Address - City:GREENBELT
Practice Address - State:MD
Practice Address - Zip Code:20770-1402
Practice Address - Country:US
Practice Address - Phone:301-220-0029
Practice Address - Fax:301-560-8058
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-19
Last Update Date:2012-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251J00000XAgenciesNursing Care