NPI: 1184292039
Provider Name: MAPLE CREST MANOR LLC
Doing Business As: MAPLE CREST MANOR
Classification: Assisted Living Facility - 3104A0625X
Entity Type: Organization
Specialization: Assisted Living, Mental Illness
CLIA Number: 26D0969649
Address:
430 N FREDERICK ST
CAPE GIRARDEAU, MO
ZIP 63701
Phone: (573) 339-7606
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MAPLE CREST MANOR LLC is an assisted living and mental illness assisted living facility in Cape Girardeau, MO. The provider is a facility providing supportive services to individuals who can function independently in most areas of activity, but need special guidance, assistance and/or monitoring as the result of a psychiatric problem. This type of facility requires a staff with special training in mental health training and dealing with psychiatric emergencies. MAPLE CREST MANOR LLC NPI is 1184292039. The provider is registered as an organization entity type.
The provider Is Doing Business As Maple Crest Manor.
The provider's business location address is:
430 N FREDERICK ST
CAPE GIRARDEAU, MO
ZIP 63701-835
Phone: (573) 339-7606
The provider's authorized official is Kevin Wood .
The authorized official title is Owner and has the following contact phone number (573) 576-3029.
The CLIA number assigned to this NPI record is 26D0969649 - assisted living facility with a certificate type of Certificate of Waiver.
The enumeration date for this NPI number is 6/16/2021 and was last updated on 6/17/2021.