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General NPI Number Information
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NPI Number | 1629668850
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Entity Type | Organization
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Legal Business Name | MAPLES LLC
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Dates
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Enumeration Date | 01/21/2021
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Last Update Date | 08/25/2023
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Provider Practice Location Address
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Address Line | 15555 GEORGE ONEAL RD
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City | BATON ROUGE
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State | LA
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Zip | 70817-1514
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Country | US
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Telephone | 225-810-4040
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Fax | 225-810-4050
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Provider Business Mailing Address
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Address Line | 14707 PERKINS RD
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City | BATON ROUGE
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State | LA
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Zip | 70810-2216
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Country | US
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Telephone | 225-810-4040
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Fax | 225-810-4050
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Authorized Official
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Title or Position | CEO
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Name | PHILLIP SEAN WENDELL
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Credential | CPA
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Telephone | 225-810-4040
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 276400000X
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Taxonomy Name | Substance Use Disorder Rehabilitation Hospital Unit
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 323P00000X
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Taxonomy Name | Psychiatric Residential Treatment Facility
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License Number |
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License Number State |
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