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Maple Leaf Behavioral Services

Early Intervention Provider Agency in Philadelphia, PA. Organization (NPI-2).

NPI number1124474697
StatusActive
Last updated in NPPESMay 13, 2016

Details

NPI
1124474697
Entity type
Organization (NPI-2)
Legal business name
Maple Leaf Behavioral Services
Organization subpart
No
Enumeration date
May 13, 2016
Last updated
May 13, 2016

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
252Y00000X Early Intervention Provider Agency––Yes

Other names

  • N/A (Doing Business As)

Practice location

1332 Disston St
Philadelphia, PA 19111-4502

Phone 267-815-8544

Mailing address

1332 Disston St
Philadelphia, PA 19111-4502

Phone 267-815-8544

Authorized official

Emmanuel Marrero
Ceo
2678158544

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