Provider Demographics
NPI:1255507364
Name:MAPLEWOOD CARE RESIDENCE
Entity Type:Organization
Organization Name:MAPLEWOOD CARE RESIDENCE
Other - Org Name:PARKINSONS SPECIALTY CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MARCIA
Authorized Official - Middle Name:SUE
Authorized Official - Last Name:DOONER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:612-597-4903
Mailing Address - Street 1:2338 OVERLOOK CIR E
Mailing Address - Street 2:
Mailing Address - City:MAPLEWOOD
Mailing Address - State:MN
Mailing Address - Zip Code:55119-5947
Mailing Address - Country:US
Mailing Address - Phone:763-550-1774
Mailing Address - Fax:
Practice Address - Street 1:2338 OVERLOOK CIR E
Practice Address - Street 2:
Practice Address - City:MAPLEWOOD
Practice Address - State:MN
Practice Address - Zip Code:55119-5947
Practice Address - Country:US
Practice Address - Phone:763-550-1774
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-08
Last Update Date:2008-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN339492251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health