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Organization
MAPLE WINDS CARE CENTER CO. LLC
Active
Organization
MAPLE WINDS CARE CENTER CO. LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JERRY WILLIAM OTTO NHA (ADMINISTRATOR)
(814) 736-6000
Entity
Organization
Contact information
Practice address
4112 SPRINGHILL ROAD, PORTAGE, PA 15946
(814) 736-6000
(814) 736-4299
Mailing address
4112 SPRINGHILL ROAD, PORTAGE, PA 15946
(814) 736-6000
(814) 736-4299
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
09750201
PA
Other
Enumeration date
06/24/2005
Last updated
02/24/2010
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