Provider Demographics
NPI:1578885752
Name:JOST ENTERPRISES
Entity Type:Organization
Organization Name:JOST ENTERPRISES
Other - Org Name:MAPLE WINDS CARE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:BOARD PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:D
Authorized Official - Last Name:PANICK
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:814-736-6000
Mailing Address - Street 1:4112 SPRINGHILL RD
Mailing Address - Street 2:
Mailing Address - City:PORTAGE
Mailing Address - State:PA
Mailing Address - Zip Code:15946-7402
Mailing Address - Country:US
Mailing Address - Phone:814-736-6000
Mailing Address - Fax:814-736-4299
Practice Address - Street 1:4112 SPRINGHILL RD
Practice Address - Street 2:
Practice Address - City:PORTAGE
Practice Address - State:PA
Practice Address - Zip Code:15946-7402
Practice Address - Country:US
Practice Address - Phone:814-736-6000
Practice Address - Fax:814-736-4299
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-16
Last Update Date:2010-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA09750201313M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes313M00000XNursing & Custodial Care FacilitiesNursing Facility/Intermediate Care Facility