Maple Shade Youth and Family Services, Inc.

Primary specialty

Respite CareTaxonomy code 385H00000X

License

1709 Issued in MD

Legal business name

MAPLE SHADE YOUTH AND FAMILY SERVICES, INC.

Practice address

23704 Ocean Gtwy
Mardela Springs, MD 21837-2101

Phone

(410) 742-7400

Fax

(410) 742-6452

NPI assigned

Oct 6, 2016

Organization subpart

No

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

Authorized official

Name

Dr. Niru Jani, MD

Title

Chief Administrator

Phone

(410) 740-7400

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1475712000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1475712000000",
    "number": "1780134486",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23704 OCEAN GTWY",
            "city": "MARDELA SPRINGS",
            "state": "MD",
            "postal_code": "218372101",
            "telephone_number": "410-742-7400",
            "fax_number": "410-742-6452"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23704 OCEAN GTWY",
            "city": "MARDELA SPRINGS",
            "state": "MD",
            "postal_code": "218372101",
            "telephone_number": "410-742-7400",
            "fax_number": "410-742-6452"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAPLE SHADE YOUTH AND FAMILY SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-06",
        "last_updated": "2016-10-06",
        "status": "A",
        "authorized_official_last_name": "JANI",
        "authorized_official_first_name": "NIRU",
        "authorized_official_title_or_position": "CHIEF ADMINISTRATOR",
        "authorized_official_telephone_number": "410-740-7400",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "385H00000X",
            "taxonomy_group": "",
            "desc": "Respite Care",
            "state": "MD",
            "license": "1709",
            "primary": true
        },
        {
            "code": "385H00000X",
            "taxonomy_group": "",
            "desc": "Respite Care",
            "state": "MD",
            "license": "MH-979",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ashley Jester, LMSW
• Julie Johnson, LGSW
• Joseph Raymond Knight, LMSW
• Maple Shade Youth & Family Services, Inc.
• Maple Shade Youth & Family Services, Inc.
• Mardela Springs Volunteer Fire Company Incorporated
• Lamont McKinney
• Tonya O'Hara, LCSW-C
• Rosa Lee Partlow
• Mark C Penland, LCPC

• Respite Care in Mardela Springs, MD
• Providers in Mardela Springs, MD by specialty
• Respite Care in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 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.