Maade LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

MAADE LLC

Practice address

11220 Elm LN Ste 202
Charlotte, NC 28277-0450

Phone

(919) 797-4615

NPI assigned

May 9, 2019

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ishmael Blount

Title

Director of Operations

Phone

(919) 797-4615

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1557360000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1557360000000",
    "number": "1154986792",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11220 ELM LN STE 202",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282770450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11220 ELM LN STE 202",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282770450",
            "telephone_number": "919-797-4615"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAADE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-05-09",
        "last_updated": "2019-05-09",
        "status": "A",
        "authorized_official_last_name": "BLOUNT",
        "authorized_official_first_name": "ISHMAEL",
        "authorized_official_title_or_position": "DIRECTOR OF OPERATIONS",
        "authorized_official_telephone_number": "919-797-4615"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.