NPIMap

Organization Active NPI

Maple Shade Youth & Family Services, Inc.

  • Community/Behavioral Health Agency
  • Crisfield, MD
National Provider Identifier
1073841052
Registry record updated Apr 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
MAPLE SHADE YOUTH & FAMILY SERVICES, INC.
Practice address
382 W Main St
Crisfield, MD 21817-1329
Phone
(410) 202-2750
NPI assigned
Dec 2, 2009
Last updated
Apr 12, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 12, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Jessica Dawn Holloway-Hill
Title
Clinical Director
Phone
(410) 621-5177

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X NU Primary

Addresses

Primary practice location

382 W Main St
Crisfield, MD 21817-1329

Mailing address

382 W Main St
Crisfield, MD 21817-1329
Phone (410) 202-2750

Other names 1

  • Crisfield Clinic Other name

National Provider Directory

National Provider Directory
Tax ID family
Maple Shade Youth Family Services Inc5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1259712000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1649721600000",
    "number": "1073841052",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "382 W MAIN ST",
            "city": "CRISFIELD",
            "state": "MD",
            "postal_code": "218171329",
            "telephone_number": "410-202-2750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "382 W MAIN ST",
            "city": "CRISFIELD",
            "state": "MD",
            "postal_code": "218171329",
            "telephone_number": "410-202-2750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAPLE SHADE YOUTH & FAMILY SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-12-02",
        "last_updated": "2022-04-12",
        "certification_date": "2022-04-12",
        "status": "A",
        "authorized_official_last_name": "HOLLOWAY-HILL",
        "authorized_official_first_name": "JESSICA",
        "authorized_official_middle_name": "DAWN",
        "authorized_official_title_or_position": "CLINICAL DIRECTOR",
        "authorized_official_telephone_number": "410-621-5177"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Crisfield Clinic",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Crisfield Clinic",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Crisfield, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.