Healthcare Provider Details

I. General information

NPI: 1417931858
Provider Name (Legal Business Name): MAPLES-BENZIE COUNTY MEDICAL CARE FACILITY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/30/2005
Last Update Date: 11/23/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

210 MAPLE AVE
FRANKFORT MI
49635-9745
US

IV. Provider business mailing address

210 MAPLE AVE
FRANKFORT MI
49635-9745
US

V. Phone/Fax

Practice location:
  • Phone: 231-352-9674
  • Fax: 231-352-5001
Mailing address:
  • Phone: 231-352-9674
  • Fax: 231-352-5001

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number108510
License Number StateMI

VIII. Authorized Official

Name: ROSE M COLEMAN
Title or Position: ADMINISTRATOR
Credential: RN NHA
Phone: 231-352-9674