MAPLEWOOD SUPPORTIVE LIVING, INC (NPI# 1245508761) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1245508761 |
| Entity Type | Organization |
| Organization Name | MAPLEWOOD SUPPORTIVE LIVING, INC |
| Practice Address |
21755 Maplewood Dr Southfield MI 48033-3601 |
| Mailing Address |
37637 5 Mile Rd #223 Livonia MI 48154-1543 |
| Practice Telephone | 7346125957 |
| Practice Fax Number | 7349564155 |
| Mailing Telephone | 7346125957 |
| Mailing Fax Number | 7349564155 |
| Enumeration Date | 2011-12-12 |
| Last Update Date | 2011-12-12 |
| Authorized Official Name | MS. DOROTHY STRONG-STOKES (PRESIDENT-CEO) |
| Authorized Official Telephone | 7346125957 |
| Authorized Official Credential | LMSW, CBIS, C-AS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 320800000X | Community Based Residential Treatment Facility, Mental Illness | AS630295056 | MI | Residential Treatment Facilities |
| Y | 320700000X | Residential Treatment Facility, Physical Disabilities | AS630295056 | MI | Residential Treatment Facilities |
| Street Address |
21755 MAPLEWOOD DR |
| City | SOUTHFIELD |
| State | MI |
| Zip Code | 48033-3601 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053862615 | Maplewood Supportive Living | Assisted Living Facility | 21755 Maplewood Dr, Southfield, MI 48033-3601 | 2016-10-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013531243 | Kenicka Harper | Case Manager/Care Coordinator | 2270 W Nine Mile Rd, Detroit, MI 48033 | 2020-06-03 |
| 1154955292 | Judy C Staples | Registered Nurse | 23800 West 10 Mile Road, Ste. 110, Southfield, MI 48033 | 2020-02-27 |
| 1578193827 | Axel Lee Gruenberg | Peer Specialist | 221790 West 9 Mile, Southfield, MI 48033 | 2020-01-24 |
| 1851958706 | William Beaumont Hospital | Clinic/Center | 26901 Beaumont Blvd., D - 5, Community Health, Southfield, MI 48033 | 2019-05-28 |
| 1396302857 | William Beaumont Hospital | Clinic/Center | Beaumont Service Center, 26901 Beaumont Blvd, Community Health, D - 5, Southfield, MI 48033 | 2019-05-21 |
| 1700442597 | Botsford General Hospital | Clinic/Center | 26901 Beaumont Blvd, Beaumont Service Center, Community Health, D - 5, Southfield, MI 48033 | 2019-05-16 |
| 1558862433 | Oakwood Accountable Care Organization, LLC | Preferred Provider Organization | 26901 Beaumont Blvd., Southfield, MI 48033 | 2018-02-26 |
| 1891228904 | Brandi Becker-wright | Social Worker | 25200 Telegraph Rd Ste 100, Southfield, MI 48033 | 2017-04-05 |
| 1003362252 | Mark Kline | Registered Nurse | 22170 W Nine Mile Rd, Southfield, MI 48033 | 2016-08-28 |
| 1033534797 | Jessica Savageau | Social Worker | 22170 W 9 Mile, Southfield, MI 48033 | 2014-03-04 |
| Find all providers in zip 48033 | ||||
| Taxonomy Code | 320700000X |
| Grouping | Residential Treatment Facilities |
| Classification | Residential Treatment Facility, Physical Disabilities |
| A residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with developmental disabilities and/or mental retardation and are not able to live independently. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083173017 | Newport Care Center | Residential Treatment Facility, Physical Disabilities | 22977 Newport St, Southfield, MI 48075-5850 | 2019-03-19 |
| 1750832564 | First Door, LLC | Residential Treatment Facility, Physical Disabilities | 25584 W 10 Mile Rd, Southfield, MI 48033-4826 | 2016-10-17 |
| 1245520972 | Choice One Investments | Residential Treatment Facility, Physical Disabilities | 25140 Waycross, Southfield, MI 48033-2232 | 2011-04-14 |
| 1386947299 | Faith Afc Inc | Residential Treatment Facility, Physical Disabilities | 30440 Old Stream St, Southfield, MI 48076-1098 | 2010-12-15 |
| 1023134400 | Irvine Head Injury,inc | Residential Treatment Facility, Physical Disabilities | 25700 Lahser Rd, Southfield, MI 48034-5809 | 2007-03-21 |
| 1659569085 | Selective Home Counseling Service | Residential Treatment Facility, Physical Disabilities | 24100 Southfield Rd, Suite 320, Southfield, MI 48075-2819 | 2007-10-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104352285 | Tukeisha Snedecar | Residential Treatment Facility, Physical Disabilities | 19210 Conley St, Detroit, MI 48234-2276 | 2017-05-10 |
| 1760925556 | Connect Care Network Inc. | Residential Treatment Facility, Physical Disabilities | 19761 Annott St, Detroit, MI 48205-1603 | 2016-11-28 |
| 1306390737 | Nikeyla Blakeney | Residential Treatment Facility, Physical Disabilities | 15384 Freeland St, Detroit, MI 48227-2911 | 2016-08-15 |
| 1558815068 | Charlie Hudson | Residential Treatment Facility, Physical Disabilities | 15831 Woodworth, Redford, MI 48239-3970 | 2016-08-12 |
| 1801249222 | Cm Org | Residential Treatment Facility, Physical Disabilities | 7621 Parkland, Detroit, MI 48239-1031 | 2016-07-20 |
| 1548635618 | Milad Jabow | Residential Treatment Facility, Physical Disabilities | 5126 Allison Dr, Troy, MI 48085-3468 | 2015-12-01 |
| 1831568500 | Expert Enterprises | Residential Treatment Facility, Physical Disabilities | 18453 Woodingham Dr Uppr, Detroit, MI 48221-2155 | 2015-09-23 |
| 1396113767 | Ltss Inc | Residential Treatment Facility, Physical Disabilities | 3801 S 39 Rd, Cadillac, MI 49601-9126 | 2015-09-02 |
| 1962879759 | Zina Alsalik | Residential Treatment Facility, Physical Disabilities | 19230 Ford Rd, Apt 710, Dearborn, MI 48128-2000 | 2015-08-27 |
| 1851786263 | Cbi Rehabilitation Services, Inc. | Residential Treatment Facility, Physical Disabilities | 3446 E Lake Lansing Rd, East Lansing, MI 48823-1511 | 2015-04-02 |
| Find all providers with the same taxonomy | ||||
| City | SOUTHFIELD |
| Zip Code | 48033 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.