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General NPI Number Information
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NPI Number | 1174728810
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Entity Type | Organization
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Legal Business Name | MAPLEWAY COMMUNITY, INC
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Dates
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Enumeration Date | 06/20/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 485 MAPLEWAY
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City | SAFETY HARBOR
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State | FL
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Zip | 34695-2959
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Country | US
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Telephone | 727-726-4171
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Fax | 727-726-4497
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Provider Business Mailing Address
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Address Line | PO BOX 1778
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City | SAFETY HARBOR
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State | FL
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Zip | 34695-1778
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Country | US
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Telephone | 727-726-4171
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Fax | 727-726-4497
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | DR. JOHN JOSEPH ROSS
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Credential | PHD
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Telephone | 727-726-4171
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3104A0625X
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Taxonomy Name | Assisted Living Facility (Mental Illness)
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License Number | 10785
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License Number State | FL
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