Maple House Shelter Care Home, Inc.

Primary specialty

Lodging ProviderTaxonomy code 177F00000X

License

0038380 Issued in IL

Legal business name

MAPLE HOUSE SHELTER CARE HOME, INC.

Practice address

205 E 3Rd St
Johnston City, IL 62951-1624

Phone

(618) 983-5731

Fax

(618) 983-7101

NPI assigned

Mar 29, 2007

Organization subpart

No

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

Authorized official

Name

Ms. Rhonda L. Jones

Title

President

Phone

(618) 983-5731

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1175126400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1588784136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 E 3RD ST",
            "address_2": "PO BOX 230",
            "city": "JOHNSTON CITY",
            "state": "IL",
            "postal_code": "629511624",
            "telephone_number": "618-983-5731",
            "fax_number": "618-983-7101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 E 3RD ST",
            "city": "JOHNSTON CITY",
            "state": "IL",
            "postal_code": "629511624",
            "telephone_number": "618-983-5731",
            "fax_number": "618-983-7101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAPLE HOUSE SHELTER CARE HOME, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-29",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "JONES",
        "authorized_official_first_name": "RHONDA",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "618-983-5731",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "177F00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Lodging",
            "state": "IL",
            "license": "0038380",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Lodging Provider in Johnston City, IL
• Providers in Johnston City, IL by specialty
• Lodging Provider in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.