Maple Creek Venture, LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

MAPLE CREEK VENTURE, LLC

Practice address

10420 Gravelly Lake Dr SW
Lakewood, WA 98499-5041

Phone

(253) 588-0227

NPI assigned

Feb 1, 2021

Organization subpart

No

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

Authorized official

Name

Carl Mason

Title

Director of Operations

Phone

(503) 826-5190

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1612137600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1612137600000",
    "number": "1114518248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25260 SW PARKWAY AVE STE B",
            "city": "WILSONVILLE",
            "state": "OR",
            "postal_code": "970706627",
            "telephone_number": "503-826-5190"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10420 GRAVELLY LAKE DR SW",
            "city": "LAKEWOOD",
            "state": "WA",
            "postal_code": "984995041",
            "telephone_number": "253-588-0227"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAPLE CREEK VENTURE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-02-01",
        "last_updated": "2021-02-01",
        "certification_date": "2021-02-01",
        "status": "A",
        "authorized_official_last_name": "MASON",
        "authorized_official_first_name": "CARL",
        "authorized_official_title_or_position": "DIRECTOR OF OPERATIONS",
        "authorized_official_telephone_number": "503-826-5190"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UBI",
            "identifier": "604-693-222",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Guinevere Mangrobang
• Celia Mae Mann, COTA/L
• Timothy J. Mann, DPT
• Tina Lynn Mansfield, BA
• Maple Creek Senior Living, LLC
• Berkeley Maple
• Whitney Joi Mapp
• Dimitrios Maragakis
• Elm-Acacia Marano
• Chaniella Maratita

• Assisted Living Facility in Lakewood, WA
• Providers in Lakewood, WA by specialty
• Assisted Living Facility in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2021; 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.