Maple Ridge Living Center

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

License

AL570303169 Issued in MI

Legal business name

MAPLE RIDGE LIVING CENTER

Practice address

2575 W Houghton Lake Rd
Lake City, MI 49651-8820

Phone

(231) 839-1011

NPI assigned

Aug 7, 2012

Organization subpart

No

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

Authorized official

Name

Jamie Kunkel, 231-839-1011

Title

Administrator/Licensee

Phone

(231) 839-1011

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1344297600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1344297600000",
    "number": "1205183449",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2575 W HOUGHTON LAKE RD",
            "address_2": "P.O. BOX 677",
            "city": "LAKE CITY",
            "state": "MI",
            "postal_code": "496518820"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2575 W HOUGHTON LAKE RD",
            "city": "LAKE CITY",
            "state": "MI",
            "postal_code": "496518820",
            "telephone_number": "231-839-1011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAPLE RIDGE LIVING CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-08-07",
        "last_updated": "2012-08-07",
        "status": "A",
        "authorized_official_last_name": "KUNKEL",
        "authorized_official_first_name": "JAMIE",
        "authorized_official_title_or_position": "ADMINISTRATOR/LICENSEE",
        "authorized_official_telephone_number": "231-839-1011",
        "authorized_official_credential": "231-839-1011"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "MI",
            "license": "AL570303169",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lake to Lake Transportation LLC
• Gregory Lambourne, M.D.
• Joseph Matthew Liestenfeltz
• Jessica Jean Lindell, FNP-C
• Jennifer Macdougall, RN
• Christin Marvin, CCC-SLP
• McBain Family Pharmacy PLLC
• Michael Frances Lahey DDS
• Missaukee County Commission on Aging
• Taylor Marie Nickerson

• Clinic/Center in Lake City, MI
• Providers in Lake City, MI by specialty
• Clinic/Center in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2012; 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.