# MAPLE LTC GROUP, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Cumberland Nursing and Rehabilitation Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1376579904
- **Authorized official:** MR. KAREN G MCDANIEL (PRESIDENT)
- **Authorized official phone:** (252) 523-9094

## Contact information

- **Practice address:** 2461 LEGION RD, FAYETTEVILLE, NC 28306-2997
- **Practice address phone:** (910) 424-9417
- **Practice address fax:** (910) 423-1409
- **Mailing address:** PO BOX 64665, FAYETTEVILLE, NC 28306-0665
- **Mailing address phone:** (910) 424-9417
- **Mailing address fax:** (910) 423-1409

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | NH0501 | NC | Yes |

## Other

- **Enumeration date:** 06/24/2006
- **Last updated:** 04/07/2017

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 00941 | BC/BS OF NC | NC |
| 05 | — | 3435376 | — | NC |
| 05 | — | 3436308 | — | NC |
| 05 | — | 3445376 | — | NC |