Organization Active NPI

Maple Leaf Behavioral Services

  • Early Intervention Provider Agency
  • Philadelphia, PA
National Provider Identifier
1124474697
Registry record updated May 13, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Early Intervention Provider AgencyTaxonomy code 252Y00000X
Legal business name
MAPLE LEAF BEHAVIORAL SERVICES
Doing business as
n/a
Practice address
1332 Disston St
Philadelphia, PA 19111-4502
Phone
(267) 815-8544
NPI assigned
May 13, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 13, 2016

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

Authorized official

Name
Mr. Emmanuel Marrero
Title
Ceo
Phone
(267) 815-8544

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Early Intervention Provider Agency 252Y00000X Primary

Addresses

Primary practice location

1332 Disston St
Philadelphia, PA 19111-4502

Mailing address

1332 Disston St
Philadelphia, PA 19111-4502
Phone (267) 815-8544

Other names 1

  • n/a Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1463097600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1463097600000",
    "number": "1124474697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1332 DISSTON ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191114502",
            "telephone_number": "267-815-8544"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1332 DISSTON ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191114502",
            "telephone_number": "267-815-8544"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAPLE LEAF BEHAVIORAL SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-05-13",
        "last_updated": "2016-05-13",
        "status": "A",
        "authorized_official_last_name": "MARRERO",
        "authorized_official_first_name": "EMMANUEL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "267-815-8544",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "252Y00000X",
            "taxonomy_group": "",
            "desc": "Early Intervention Provider Agency",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "n/a",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Philadelphia, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2016; 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.