MEDICARE: MAPLEWOOD PARK RETIREMENT SERVICES INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	314000000X	Skilled Nursing Facility	15-065	MD

General Provider Information

NPI Number	:	1275582140
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MAPLEWOOD PARK RETIREMENT SERVICES INC

Provider Business Mailing Address
First Line	:	9707 OLD GEORGETOWN RD
Second Line	:
City	:	BETHESDA
State	:	MD
Zip	:	20814-1745
Country	:	US
Telephone Number	:	15-300-5003
Fax Number	:	301-571-7411

Provider Business Practice Location Address
First Line	:	9707 OLD GEORGETOWN RD
Second Line	:
City	:	BETHESDA
State	:	MD
Zip	:	20814-1745
Country	:	US
Telephone Number	:	301-530-0500
Fax Number	:	301-571-7411

Authorized Official
Title or Position	:	SENIOR REIMBURSEMENT MANAGER
Name	:	MR. TONY J. HARRIS
Credential	:
Telephone Number	:	703-854-0830

Provider Enumeration Date	:	05/09/2006
Last Update Date	:	12/17/2024

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