Madam LLC

NPI #1073856340 in Manor, Texas

Provider Information

NPI Number: 1073856340
Entity Type: Organization
Organization Name: Madam LLC
Primary Specialty: Clinic/Center - Rehabilitation, Substance Use Disorder
Enumeration Date: Apr 4, 2013
Last Updated: Apr 4, 2013

Practice Location

Address: 11503 PARSONS RD
City: Manor
State: Texas
ZIP Code: 78653-5220
Phone: (954) 678-0078

Authorized Official

Name: MARSHA STONE
Title: OWNER
Phone: (954) 678-0078

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Clinical Medical Laboratory	291U00000X
Clinic/Center - Rehabilitation, Substance Use Disorder — Rehabilitation, Substance Use Disorder	261QR0405X	Primary

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