# MAPLEMANOR CHRISTIAN HOME, INC.

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

## Provider details

- **NPI number:** 1124494760
- **Authorized official:** MRS. KATHERINE L. WILSON (ACCOUNTING CLERK)
- **Authorized official phone:** (812) 246-4866

## Contact information

- **Practice address:** 643 W UTICA ST, SELLERSBURG, IN 47172-1163
- **Practice address phone:** (812) 246-4866
- **Practice address fax:** (812) 246-3925
- **Mailing address:** 643 W UTICA ST, SELLERSBURG, IN 47172-1163
- **Mailing address phone:** (812) 246-4866
- **Mailing address fax:** (812) 246-3925

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 313M00000X | Nursing Facility/Intermediate Care Facility | 15-000563-1 | IN | Yes |

## Other

- **Enumeration date:** 08/18/2015
- **Last updated:** 08/18/2015

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 100267610A | — | IN |