| NPI | 1801364393 |
|---|---|
| Doing Business As | MAPLE LANE NURSING HOME |
| Entity Type | Organization |
| Authorized Contact | JOHN WYNNE CFO 203-904-7462 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 314000000X Skilled Nursing Facility |
| Enumeration Date | 2018-11-02 |
| Last Update Date | 2018-11-02 |