# MAPLE SHADE HEALTHCARE LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Maple Shade Wellness and Recovery
- **Organization subpart:** No

## Provider details

- **NPI number:** 1205600756
- **Authorized official:** ABE PHILLIP (MEMBER)
- **Authorized official phone:** (877) 567-0402

## Contact information

- **Practice address:** 794 N FORKLANDING RD, MAPLE SHADE, NJ 08052-1049
- **Practice address phone:** (856) 779-9333
- **Practice address fax:** (856) 779-1317
- **Mailing address:** 630 HERMAN RD, JACKSON, NJ 08527-3081
- **Mailing address phone:** (877) 567-0402

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 313M00000X | Nursing Facility/Intermediate Care Facility | — | — | — |
| 314000000X | Skilled Nursing Facility | — | — | Yes |
| 385H00000X | Respite Care | — | — | — |

## Other

- **Enumeration date:** 11/14/2023
- **Last updated:** 11/14/2023