Maple Manor Nursing Center, Inc

Primary specialty

Nursing Facility/Intermediate Care FacilityTaxonomy code 313M00000X

License

664020 Issued in MI

Legal business name

MAPLE MANOR NURSING CENTER, INC

Practice address

102 2ND St
Ontonagon, MI 49953-1337

Phone

(906) 884-2882

Fax

(906) 884-2885

NPI assigned

Sep 29, 2005

Last updated

Aug 7, 2007By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Lawrence J Kutz

Title

Owner

Phone

(715) 561-3200

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1127952000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1186444800000",
    "number": "1053308734",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 VILLA DR",
            "city": "HURLEY",
            "state": "WI",
            "postal_code": "545341523",
            "telephone_number": "715-561-3200",
            "fax_number": "715-561-5556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 2ND ST",
            "city": "ONTONAGON",
            "state": "MI",
            "postal_code": "499531337",
            "telephone_number": "906-884-2882",
            "fax_number": "906-884-2885"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAPLE MANOR NURSING CENTER, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-29",
        "last_updated": "2007-08-07",
        "status": "A",
        "authorized_official_last_name": "KUTZ",
        "authorized_official_first_name": "LAWRENCE",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "715-561-3200",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "313M00000X",
            "taxonomy_group": "",
            "desc": "Nursing Facility/Intermediate Care Facility",
            "state": "MI",
            "license": "664020",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2082408",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jessica Brooke Huntzinger, RN
• Robert J Johnson, D.D.S.
• Ryan Kaiponen
• Colleen Marie Lundgren, PTA
• Eric Andrew Maki, M.D.
• Suzanne J Miron, NP-C
• Northern Wisconsin Bone & Joint
• Rachel Marie Nowicki
• Jacek Olszewski, PT
• Ontonagon Community Health Center

• Nursing Facility/Intermediate Care Facility in Ontonagon, MI
• Providers in Ontonagon, MI by specialty
• Nursing Facility/Intermediate Care Facility in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.