Provider Demographics
NPI:1932256856
Name:BRANCH COUNTY TREASURER
Entity Type:Organization
Organization Name:BRANCH COUNTY TREASURER
Other - Org Name:MAPLE LAWN MEDICAL CARE FACILITY
Other - Org Type:Other Name
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:JAYNE
Authorized Official - Middle Name:A
Authorized Official - Last Name:SABAITIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:517-279-9587
Mailing Address - Street 1:50 SANDERSON LN
Mailing Address - Street 2:
Mailing Address - City:COLDWATER
Mailing Address - State:MI
Mailing Address - Zip Code:49036-2228
Mailing Address - Country:US
Mailing Address - Phone:517-279-9587
Mailing Address - Fax:517-279-8304
Practice Address - Street 1:50 SANDERSON LN
Practice Address - Street 2:
Practice Address - City:COLDWATER
Practice Address - State:MI
Practice Address - Zip Code:49036-2228
Practice Address - Country:US
Practice Address - Phone:517-279-9587
Practice Address - Fax:517-279-8304
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-04
Last Update Date:2014-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI128511314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
09636OtherBLUE CROSS BLUE SHIELD
MI2085016Medicaid
235008Medicare ID - Type Unspecified