Provider Demographics
NPI:1043217409
Name:MAPLE HEALTH SERVICES, INC.
Entity type:Organization
Organization Name:MAPLE HEALTH SERVICES, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:LOUIS
Authorized Official - Middle Name:HERSHEL
Authorized Official - Last Name:KRAUS
Authorized Official - Suffix:
Authorized Official - Credentials:LNHA
Authorized Official - Phone:216-662-0551
Mailing Address - Street 1:16231 BROADWAY AVE
Mailing Address - Street 2:
Mailing Address - City:MAPLE HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44137-2526
Mailing Address - Country:US
Mailing Address - Phone:216-662-0551
Mailing Address - Fax:216-662-7754
Practice Address - Street 1:16231 BROADWAY AVE
Practice Address - Street 2:
Practice Address - City:MAPLE HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44137-2526
Practice Address - Country:US
Practice Address - Phone:216-662-0551
Practice Address - Fax:216-662-7754
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3830314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0680044Medicaid
OH0680044Medicaid