Maple Hollow Rehabilitation and Nursing LLC

Primary specialty

Nursing Facility/Intermediate Care FacilityTaxonomy code 313M00000X

Legal business name

MAPLE HOLLOW REHABILITATION AND NURSING LLC

Practice address

34 NE 20TH Ave
Portland, OR 97232-3019

Phone

(503) 231-0276

NPI assigned

Oct 11, 2018

Organization subpart

No

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

Authorized official

Name

Walter Eric Myers

Title

Managing Member

Phone

(801) 709-4358

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1539216000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1539216000000",
    "number": "1114492519",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "34 NE 20TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972323019"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "34 NE 20TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972323019",
            "telephone_number": "503-231-0276"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAPLE HOLLOW REHABILITATION AND NURSING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-10-11",
        "last_updated": "2018-10-11",
        "status": "A",
        "authorized_official_last_name": "MYERS",
        "authorized_official_first_name": "WALTER",
        "authorized_official_middle_name": "ERIC",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "801-709-4358"
    },
    "taxonomies": [
        {
            "code": "313M00000X",
            "taxonomy_group": "",
            "desc": "Nursing Facility/Intermediate Care Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rachel Baumann Manzo, MD
• Jessica Joy Manzoni, RN
• Rui-Min Diana Mao, MD
• Louise Mapham
• Maple Counseling LLC
• Maple Star Oregon, Inc.
• Hannah Maple
• Kacie Lynn Maplethorpe, LPC, LMHC, MA
• Maria Regina Maplethorpe
• Casey Mapp

• Nursing Facility/Intermediate Care Facility in Portland, OR
• Providers in Portland, OR by specialty
• Nursing Facility/Intermediate Care Facility in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2018; 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.