Healthcare Provider Details

I. General information

NPI: 1881503449
Provider Name (Legal Business Name): MAPLE LIFE SENIOR LIVING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/01/2026
Last Update Date: 09/01/2026
Certification Date: 09/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4802 BRISA DR
PALMDALE CA
93551-2743
US

IV. Provider business mailing address

4802 BRISA DR
PALMDALE CA
93551-2743
US

V. Phone/Fax

Practice location:
  • Phone: 661-206-7562
  • Fax: 661-206-7115
Mailing address:
  • Phone: 661-206-7562
  • Fax: 661-206-7115

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number State

VIII. Authorized Official

Name: MERLYN ESTRADA
Title or Position: CEO
Credential:
Phone: 661-206-7562