NPIMap

Organization Active NPI

Maple Manor Nursing and Rehab LLC

  • Skilled Nursing Facility
  • Rochester, MN
National Provider Identifier
1184020612
Registry record updated Sep 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
MAPLE MANOR NURSING AND REHAB LLC
Practice address
1875 19TH St NW
Rochester, MN 55901-1633
Phone
(507) 282-9449
NPI assigned
Nov 11, 2014
Last updated
Sep 16, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2020

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

Authorized official

Name
Max Stesel
Title
Member
Phone
(773) 825-3336

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X Primary

Addresses

Primary practice location

1875 19TH St NW
Rochester, MN 55901-1633

Mailing address

8170 McCormick Blvd
Ste 112
Skokie, IL 60076-2961
Phone (773) 825-3336

Other identifiers 1

IdentifierTypeStateIssuer
843242200MedicaidMN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150213000253 MN Part A Provider - Skilled Nursing Facility 3678898707 Practice locations: Rochester, MN

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1184020612. Details of each certification follow.

Skilled nursing facility certification: CCN 245409

Legal name
MAPLE MANOR NURSING AND REHAB LLC
Doing business as
EDENBROOK OF ROCHESTER
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Jan 1, 1987
Last certification
May 1, 2025
Beds
81
Ownership / control type
Corporation
Multi-facility organization
Eden Senior Care
Organization structure
LLCProprietary
Incorporated
Oct 14, 2014 in MN
Enrollment address
1875 19TH St NW
Rochester, MN 55901-1633
Nursing home name
EDENBROOK OF ROCHESTER
Affiliated entity
EDEN SENIOR CARE

Care Compare: Nursing home

Medicare Care Compare
Listed as
Edenbrook of RochesterCCN 245409 · All quality measures
Overall star rating
2 of 5
Health inspections
2 of 5
Staffing
4 of 5
Quality measures
4 of 5
Type
Medicare and Medicaid
Ownership
For profit - Corporation
Certified
Jan 1, 1987
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
8151.9 residents per day on average
Chain
Eden Senior Care21 facilities in the chain
Penalties (3 years)
3Fines totaling $53,260

Processed by Care Compare on Aug 1, 2026.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
24D0676230Maple Manor Nursing & Rehab LLC1875 19TH Street NW, Rochester, MN 55901Certificate of waiverAug 31, 2026

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 2

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Pamela D Rice Individual Operational/Managerial ControlDirector of Revenue Mar 1, 2017
Maxim Stesel Individual 5% Or Greater Direct Ownership Interest Jul 7, 2016 100%

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

Affiliated clinicians 2

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1415664000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1600214400000",
    "number": "1184020612",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8170 MCCORMICK BLVD",
            "address_2": "STE 112",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600762961",
            "telephone_number": "773-825-3336",
            "fax_number": "773-570-4554"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1875 19TH ST NW",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "559011633",
            "telephone_number": "507-282-9449"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAPLE MANOR NURSING AND REHAB LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-11-11",
        "last_updated": "2020-09-16",
        "certification_date": "2020-09-16",
        "status": "A",
        "authorized_official_last_name": "STESEL",
        "authorized_official_first_name": "MAX",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "773-825-3336"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "843242200",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester, MN

Sources for this page

Verify at the official NPI Registry.