Provider Demographics
NPI:1578708608
Name:MARIS GROVE, INC.
Entity Type:Organization
Organization Name:MARIS GROVE, INC.
Other - Org Name:MARIS GROVE VISITING NURSE SERVICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:MAUREEN
Authorized Official - Middle Name:K
Authorized Official - Last Name:HECKLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-387-4490
Mailing Address - Street 1:200 MARIS GROVE WAY
Mailing Address - Street 2:
Mailing Address - City:GLEN MILLS
Mailing Address - State:PA
Mailing Address - Zip Code:19342-3336
Mailing Address - Country:US
Mailing Address - Phone:610-387-4470
Mailing Address - Fax:
Practice Address - Street 1:200 MARIS GROVE WAY
Practice Address - Street 2:
Practice Address - City:GLEN MILLS
Practice Address - State:PA
Practice Address - Zip Code:19342-3336
Practice Address - Country:US
Practice Address - Phone:610-387-4470
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-03
Last Update Date:2010-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health