Maplewood Homes Assisted Living

Primary specialty

Intellectual & Developmental Disabilities PsychologistTaxonomy code 103TM1800X

License

332188 Issued in MN

Legal business name

MAPLEWOOD HOMES ASSISTED LIVING

Practice address

326 7TH St NW
Faribault, MN 55021-4271

Phone

(507) 332-4071

NPI assigned

Dec 27, 2006

Organization subpart

No

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

Authorized official

Name

Mr. John Arthur Wallgren

Title

Owner

Phone

(507) 332-4071

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1167177600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1952466005",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "326 7TH ST NW",
            "city": "FARIBAULT",
            "state": "MN",
            "postal_code": "550214271",
            "telephone_number": "507-332-4071"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "326 7TH ST NW",
            "city": "FARIBAULT",
            "state": "MN",
            "postal_code": "550214271",
            "telephone_number": "507-332-4071"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAPLEWOOD HOMES ASSISTED LIVING",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-27",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WALLGREN",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "ARTHUR",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "507-332-4071",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "103TM1800X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychologist, Intellectual & Developmental Disabilities",
            "state": "MN",
            "license": "332188",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Reena Madhok, OD
• Lisa R Malecha, LPCC
• Abigail Malmanger, DMD
• David Earl Malmanger, O.D.
• Thomas Arthur Mans, ADT
• Mark L Ohlsen
• Alyssa Markos
• Hope Michelle Martinez, APRN, CNP
• Kathleen M Mason, LRD
• Taylor Dianne Matakis, CPM

• Intellectual & Developmental Disabilities Psychologist in Faribault, MN
• Providers in Faribault, MN by specialty
• Intellectual & Developmental Disabilities Psychologist in Minnesota

• 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.