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Organization

GOLDEN MAPLE HOMES, INC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. CAROL FILLMORE DNP (OWNER)
(952) 393-3690
Entity
Organization

Contact information

Practice address
13104 GIRARD AVE S, BURNSVILLE, MN 55337-2408
(952) 393-3690
Mailing address
13104 GIRARD AVE S, BURNSVILLE, MN 55337-2408

Taxonomy

Speciality
Code
Description
License number
State
311Z00000X
Custodial Care Facility
Primary
32150
MN
311ZA0620X
Adult Care Home Facility
32150
MN
315D00000X
Inpatient Hospice
32150
MN

Other

Enumeration date
03/03/2016
Last updated
03/03/2016
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