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General NPI Number Information
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NPI Number | 1720073414
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Entity Type | Organization
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Legal Business Name | MAPLE LAWN HEALTH CENTER
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Dates
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Enumeration Date | 09/19/2005
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Last Update Date | 11/01/2016
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Provider Practice Location Address
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Address Line | 700 N MAIN ST
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City | EUREKA
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State | IL
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Zip | 61530-1085
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Country | US
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Telephone | 309-467-2337
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Fax | 309-467-9011
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Provider Business Mailing Address
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Address Line | 700 N MAIN ST
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City | EUREKA
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State | IL
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Zip | 61530-1085
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Country | US
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Telephone | 309-467-2337
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Fax | 309-467-9011
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MR. JORDAN T POST
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Credential |
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Telephone | 309-467-9059
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number | 0042424
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number | 1694647
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License Number State | IL
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Taxonomy #3
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number |
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License Number State | IL
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