Provider Demographics
NPI:1093045304
Name:MAPLE SHADE YOUTH & FAMILY SERVICES, INC.
Entity Type:Organization
Organization Name:MAPLE SHADE YOUTH & FAMILY SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:NIRU
Authorized Official - Middle Name:
Authorized Official - Last Name:JANI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-742-7400
Mailing Address - Street 1:11760 SOMERSET AVE STE A
Mailing Address - Street 2:
Mailing Address - City:PRINCESS ANNE
Mailing Address - State:MD
Mailing Address - Zip Code:21853-1239
Mailing Address - Country:US
Mailing Address - Phone:410-621-5177
Mailing Address - Fax:410-621-5051
Practice Address - Street 1:11760 SOMERSET AVE
Practice Address - Street 2:
Practice Address - City:PRINCESS ANNE
Practice Address - State:MD
Practice Address - Zip Code:21853-1239
Practice Address - Country:US
Practice Address - Phone:410-621-5177
Practice Address - Fax:410-621-5051
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-08
Last Update Date:2024-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management