Maple Lake Assisted Living

Primary specialty

Exclusive Provider OrganizationTaxonomy code 302F00000X

License

AH800315846 Issued in MI

Legal business name

MAPLE LAKE ASSISTED LIVING

Practice address

677 Hazen St
Paw Paw, MI 49079-1010

Phone

(269) 657-0190

Fax

(269) 657-4290

NPI assigned

Aug 20, 2013

Organization subpart

Yes

Parent organization

LEISURE LIVING MANAGEMENTAs reported in NPPES

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

Authorized official

Name

Ms. Lindsey Haley

Title

Director of Operations

Phone

(616) 901-2986

Specialties & licenses 1

Addresses

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

CLIA laboratory certificates

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

{
    "created_epoch": "1376956800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1376956800000",
    "number": "1306279740",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3196 KRAFT AVE SE",
            "address_2": "SUITE 200",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495122078",
            "telephone_number": "616-464-1564",
            "fax_number": "616-464-2470"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "677 HAZEN ST",
            "city": "PAW PAW",
            "state": "MI",
            "postal_code": "490791010",
            "telephone_number": "269-657-0190",
            "fax_number": "269-657-4290"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAPLE LAKE ASSISTED LIVING",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "LEISURE LIVING MANAGEMENT",
        "enumeration_date": "2013-08-20",
        "last_updated": "2013-08-20",
        "status": "A",
        "authorized_official_last_name": "HALEY",
        "authorized_official_first_name": "LINDSEY",
        "authorized_official_title_or_position": "DIRECTOR OF OPERATIONS",
        "authorized_official_telephone_number": "616-901-2986",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "302F00000X",
            "taxonomy_group": "",
            "desc": "Exclusive Provider Organization",
            "state": "MI",
            "license": "AH800315846",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lynne Marie Lounsbury, CNP
• Darrin Patrick Lund, D.O.
• Patrick Michael Lynch, R.PH.
• David Patrick Mahon
• Gudrun E Mahrle, RN
• Maple Lake Chiropractic
• Maplelakebuilders
• Mapleview Consultation Center PC
• Nicole Marion
• Kathleen Ann Marquette, M.A.L.L.P.

• Exclusive Provider Organization in Paw Paw, MI
• Providers in Paw Paw, MI by specialty
• Exclusive Provider Organization in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.