Provider Demographics
NPI:1508347642
Name:MAPLEWOOD GROUP AFC LLC
Entity Type:Organization
Organization Name:MAPLEWOOD GROUP AFC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER - MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:RAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:PRESAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:517-927-7996
Mailing Address - Street 1:PO BOX 508
Mailing Address - Street 2:
Mailing Address - City:EATON RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:48827-0508
Mailing Address - Country:US
Mailing Address - Phone:517-663-4203
Mailing Address - Fax:
Practice Address - Street 1:11300 COLUMBIA HWY
Practice Address - Street 2:
Practice Address - City:EATON RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:48827-9276
Practice Address - Country:US
Practice Address - Phone:517-663-4203
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-27
Last Update Date:2018-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIAM230388711311ZA0620X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home