Provider Demographics
NPI:1568575967
Name:MAPLES REHABILITATION AND NURSING
Entity Type:Organization
Organization Name:MAPLES REHABILITATION AND NURSING
Other - Org Name:MAPLES REHABILITATION AND NURSING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:BUSINESS OFFICE/MIS DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:TERRI
Authorized Official - Middle Name:L
Authorized Official - Last Name:WADE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:508-384-7977
Mailing Address - Street 1:90 TAUNTON ST
Mailing Address - Street 2:
Mailing Address - City:WRENTHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02093-1349
Mailing Address - Country:US
Mailing Address - Phone:508-384-7977
Mailing Address - Fax:508-384-3208
Practice Address - Street 1:90 TAUNTON ST
Practice Address - Street 2:
Practice Address - City:WRENTHAM
Practice Address - State:MA
Practice Address - Zip Code:02093-1349
Practice Address - Country:US
Practice Address - Phone:508-384-7977
Practice Address - Fax:508-384-3208
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-17
Last Update Date:2011-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA0914533314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0914533Medicaid
MA0914533Medicaid