Provider Demographics
NPI:1043509946
Name:MAPLE CREEK HOME HEALTH AND HOSPICE
Entity Type:Organization
Organization Name:MAPLE CREEK HOME HEALTH AND HOSPICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:LOUISE
Authorized Official - Last Name:DEXTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:801-798-5333
Mailing Address - Street 1:290 WEST CENTER STREET
Mailing Address - Street 2:
Mailing Address - City:SPANISH FORK
Mailing Address - State:UT
Mailing Address - Zip Code:84660-2023
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:290 WEST CENTER STREET
Practice Address - Street 2:
Practice Address - City:SPANISH FORK
Practice Address - State:UT
Practice Address - Zip Code:84660-2023
Practice Address - Country:US
Practice Address - Phone:801-423-8010
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-31
Last Update Date:2016-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based