Provider Demographics
NPI:1285904672
Name:MAPLE WOODS INC
Entity type:Organization
Organization Name:MAPLE WOODS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:DEAN
Authorized Official - Middle Name:LEONARD
Authorized Official - Last Name:DICKSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:218-999-9072
Mailing Address - Street 1:40170 COUNTY ROAD 257
Mailing Address - Street 2:
Mailing Address - City:COHASSET
Mailing Address - State:MN
Mailing Address - Zip Code:55721-8826
Mailing Address - Country:US
Mailing Address - Phone:218-999-9072
Mailing Address - Fax:218-999-9068
Practice Address - Street 1:40170 COUNTY ROAD 257
Practice Address - Street 2:
Practice Address - City:COHASSET
Practice Address - State:MN
Practice Address - Zip Code:55721-8826
Practice Address - Country:US
Practice Address - Phone:218-999-9072
Practice Address - Fax:218-999-9068
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-03
Last Update Date:2012-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility