Provider Demographics
NPI:1003280249
Name:JAPAN MAPLE HEALTH
Entity Type:Organization
Organization Name:JAPAN MAPLE HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LPN
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:CHARLES
Authorized Official - Last Name:ALBERT
Authorized Official - Suffix:
Authorized Official - Credentials:LPN
Authorized Official - Phone:724-602-8866
Mailing Address - Street 1:207 W LIBERTY RD
Mailing Address - Street 2:
Mailing Address - City:SLIPPERY ROCK
Mailing Address - State:PA
Mailing Address - Zip Code:16057-5307
Mailing Address - Country:US
Mailing Address - Phone:724-602-8866
Mailing Address - Fax:724-406-0024
Practice Address - Street 1:207 W LIBERTY RD
Practice Address - Street 2:
Practice Address - City:SLIPPERY ROCK
Practice Address - State:PA
Practice Address - Zip Code:16057-5307
Practice Address - Country:US
Practice Address - Phone:724-602-8866
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-11-27
Last Update Date:2015-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health