Maple Winds Care Center Co. LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

09750201 Issued in PA

Legal business name

MAPLE WINDS CARE CENTER CO. LLC

Practice address

4112 Springhill Road
Portage, PA 15946

Phone

(814) 736-6000

Fax

(814) 736-4299

NPI assigned

Jun 24, 2005

Organization subpart

No

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

Authorized official

Name

Mr. Jerry William Otto, NHA

Title

Administrator

Phone

(814) 736-6000

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1119571200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1266969600000",
    "number": "1851397707",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4112 SPRINGHILL ROAD",
            "city": "PORTAGE",
            "state": "PA",
            "postal_code": "15946",
            "telephone_number": "814-736-6000",
            "fax_number": "814-736-4299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4112 SPRINGHILL ROAD",
            "city": "PORTAGE",
            "state": "PA",
            "postal_code": "15946",
            "telephone_number": "814-736-6000",
            "fax_number": "814-736-4299"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAPLE WINDS CARE CENTER CO. LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-24",
        "last_updated": "2010-02-24",
        "status": "A",
        "authorized_official_last_name": "OTTO",
        "authorized_official_first_name": "JERRY",
        "authorized_official_middle_name": "WILLIAM",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "814-736-6000",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "NHA"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "PA",
            "license": "09750201",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marcie A. Kovalsky, MS, CCC-SLP
• Kaitlyn Long, OTR/L
• Joshua Thomas Madison, PT
• Mainline CPL, LLC
• Chelsea Lyn Maloskey, M.S., CCC-SLP
• Maple Winds Healthcare and Rehabilitation Center, LLC
• Thomas Edward McCabe, PTA
• Tiffany McCoy, DPT
• Ashley Nichole McGough, M.S., CCC-SLP
• Kristen Marie McGough, PHARMD

• Skilled Nursing Facility in Portage, PA
• Providers in Portage, PA by specialty
• Skilled Nursing Facility in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2010; 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.