Provider Demographics
NPI:1215508783
Name:MAO DEVELOPMENT LLC
Entity type:Organization
Organization Name:MAO DEVELOPMENT LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRETOR
Authorized Official - Prefix:
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:S
Authorized Official - Last Name:CHRISTIAN
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:804-495-9266
Mailing Address - Street 1:825 WALES DR
Mailing Address - Street 2:
Mailing Address - City:HENRICO
Mailing Address - State:VA
Mailing Address - Zip Code:23075-1533
Mailing Address - Country:US
Mailing Address - Phone:180-449-5926
Mailing Address - Fax:757-231-3272
Practice Address - Street 1:825 WALES DR
Practice Address - Street 2:
Practice Address - City:HENRICO
Practice Address - State:VA
Practice Address - Zip Code:23075-1533
Practice Address - Country:US
Practice Address - Phone:180-449-5926
Practice Address - Fax:757-231-3272
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-06
Last Update Date:2022-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163W00000XNursing Service ProvidersRegistered NurseGroup - Multi-Specialty