# MAPLE MANOR NURSING CENTER, INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1053308734
- **Authorized official:** MR. LAWRENCE J KUTZ (OWNER)
- **Authorized official phone:** (715) 561-3200

## Contact information

- **Practice address:** 102 2ND ST, ONTONAGON, MI 49953-1337
- **Practice address phone:** (906) 884-2882
- **Practice address fax:** (906) 884-2885
- **Mailing address:** 300 VILLA DR, HURLEY, WI 54534-1523
- **Mailing address phone:** (715) 561-3200
- **Mailing address fax:** (715) 561-5556

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 313M00000X | Nursing Facility/Intermediate Care Facility | 664020 | MI | Yes |

## Other

- **Enumeration date:** 09/29/2005
- **Last updated:** 08/07/2007

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 2082408 | — | MI |