Healthcare Provider Details

I. General information

NPI: 1083158596
Provider Name (Legal Business Name): MAPLEWOOD OPERATING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/19/2016
Last Update Date: 03/01/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

125 W SCHOOL HOUSE LN
PHILADELPHIA PA
19144-3348
US

IV. Provider business mailing address

22 DIKE DR
MONSEY NY
10952-1114
US

V. Phone/Fax

Practice location:
  • Phone: 215-844-8806
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

Name: JACOB ZAHLER
Title or Position: MEMBER
Credential:
Phone: 908-912-2700