Provider Demographics
NPI:1922319532
Name:MAPLE MANAGEMENT LC
Entity Type:Organization
Organization Name:MAPLE MANAGEMENT LC
Other - Org Name:MAPLE SENIOR LIVING OF NEVADA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:
Authorized Official - Last Name:YOUNT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:405-705-2420
Mailing Address - Street 1:1505 E ASHLAND ST
Mailing Address - Street 2:
Mailing Address - City:NEVADA
Mailing Address - State:MO
Mailing Address - Zip Code:64772-4025
Mailing Address - Country:US
Mailing Address - Phone:417-667-3900
Mailing Address - Fax:
Practice Address - Street 1:1505 E ASHLAND ST
Practice Address - Street 2:
Practice Address - City:NEVADA
Practice Address - State:MO
Practice Address - Zip Code:64772-4025
Practice Address - Country:US
Practice Address - Phone:417-667-3900
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-29
Last Update Date:2010-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO038234310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility