Organization
MAPLE GROVE SENIOR LIVING
Active
Other names
Maple Grove Senior Living
Organization subpart
No
Provider details
NPI number
Authorized official
JASON VANDERVEER (ADMINISTRATOR)
(641) 856-2757
Entity
Organization
Contact information
Practice address
1917 S 18TH ST, CENTERVILLE, IA 52544-3136
(641) 856-2757
(641) 856-2762
Mailing address
1917 S 18TH ST, CENTERVILLE, IA 52544-3136
(641) 856-2757
(641) 856-2762
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
S0088
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0262576
—
IA
Enumeration date
05/15/2007
Last updated
08/22/2020
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