Provider Demographics
NPI:1891105409
Name:MAP PA LLC
Entity Type:Organization
Organization Name:MAP PA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARGARET
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:BUTTS
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:704-293-7969
Mailing Address - Street 1:3206 ELM ST
Mailing Address - Street 2:
Mailing Address - City:HARRISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17109-5745
Mailing Address - Country:US
Mailing Address - Phone:704-293-7969
Mailing Address - Fax:
Practice Address - Street 1:2814 GREEN ST
Practice Address - Street 2:
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17110-1266
Practice Address - Country:US
Practice Address - Phone:704-293-7969
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-05
Last Update Date:2014-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health