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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