# MAPLE WINDS CARE CENTER CO. LLC

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

## Provider details

- **NPI number:** 1851397707
- **Authorized official:** MR. JERRY WILLIAM OTTO NHA (ADMINISTRATOR)
- **Authorized official phone:** (814) 736-6000

## Contact information

- **Practice address:** 4112 SPRINGHILL ROAD, PORTAGE, PA 15946
- **Practice address phone:** (814) 736-6000
- **Practice address fax:** (814) 736-4299
- **Mailing address:** 4112 SPRINGHILL ROAD, PORTAGE, PA 15946
- **Mailing address phone:** (814) 736-6000
- **Mailing address fax:** (814) 736-4299

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | 09750201 | PA | Yes |

## Other

- **Enumeration date:** 06/24/2005
- **Last updated:** 02/24/2010