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Contact Information

MAPLE LTC GROUP, LLC
1839 ONSLOW DR. EXT.
JACKSONVILLE, NC28540
 Phone: 910-455-3610
 Fax: 910-455-3993
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Skilled Nursing Facility

314000000X A1[8] Skilled Nursing Facility
Indicates primary specialty

NPI Profile & details for MAPLE LTC GROUP, LLC

NPI Number 1558393835
LBN Legal business name MAPLE LTC GROUP, LLC
Authorized official GALE BOICE - (CFO)
Entity Organization
Organization subpart 1 No
Enumeration date 07/07/2006
Last updated 07/14/2021 - About 5 years ago
Identifiers
NC License # NH0370
NC Medicaid 3425072
NC Medicaid 3496587
NC Other 00892 BLUE CROSS/BLUE SHIELD
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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