MAPLE RIDGE CARE CENTRE LLC (NPI# 1609852847) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609852847 |
| Entity Type | Organization |
| Organization Name | MAPLE RIDGE CARE CENTRE LLC |
| Practice Address |
2202 N Kickapoo St Lincoln IL 62656-1306 |
| Practice Telephone | 2177351538 |
| Practice Fax Number | 2177324818 |
| Mailing Telephone | 2177351538 |
| Mailing Fax Number | 2177324818 |
| Enumeration Date | 2005-12-20 |
| Last Update Date | 2011-10-04 |
| Authorized Official Name | MR. MICHAEL CHARLES BRAUN (CONTROLLER) |
| Authorized Official Telephone | 8475830100 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 314000000X | Skilled Nursing Facility | 42366 | IL | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | IDPH LICENSE NUMBER | 42366 | 01 |
| IL | IDPH FACILITY NUMBER | 6005490 | 01 |
| Street Address |
2202 N KICKAPOO ST |
| City | LINCOLN |
| State | IL |
| Zip Code | 62656-1306 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881101079 | Generations At Lincoln, LLC | Skilled Nursing Facility | 2202 N Kickapoo St, Lincoln, IL 62656-1306 | 2018-01-09 |
| 1306113667 | Symphony Maple Ridge LLC | Skilled Nursing Facility | 2202 N Kickapoo St, Lincoln, IL 62656-1306 | 2011-11-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437678943 | Carissa Jo O'donoghue | Speech-Language Pathologist | 1000 Railer Way, Lincoln, IL 62656 | 2017-09-15 |
| 1083972012 | Cynthia Dorchinecz | Speech-Language Pathologist | 200 Fifth Street, Lincoln, IL 62656 | 2012-04-27 |
| 1104100114 | Jan E Fehrenbacher | Pharmacist | 603 Woodlawn, Lincoln, IL 62656 | 2011-10-10 |
| 1053633263 | Tazwood Mental Health Center, Inc. | Community/Behavioral Health | 124-126 S. Chicago Street, Lincoln, IL 62656 | 2010-02-16 |
| 1649428756 | Diane E Ulrich | Dentist | 400 N. Chicago St, Lincoln, IL 62656 | 2008-09-03 |
| 1922202944 | Robert C Miller | Dentist | 217 S Kickapoo St, Lincoln, IL 62656 | 2007-06-13 |
| 1720290638 | Lifetime Dental Care of Illinois, PC | Dentist | 411 Keokuk Street, Lincoln, IL 62656 | 2007-05-04 |
| 1982734539 | Wal-mart Stores, Inc. Dba Wal-mart | Technician/Technologist | 825 Malerich Dr., Lincoln, IL 62656 | 2007-03-06 |
| 1861571663 | David R Hepler II | Chiropractor | 2000 Pulaski Street, Lincoln, IL 62656 | 2006-11-03 |
| 1477561793 | Raymond Todd Nobbe | Optometrist | 1400 Woodlawn Road, Lincoln, IL 62656 | 2006-08-03 |
| Find all providers in zip 62656 | ||||
| Taxonomy Code | 314000000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Skilled Nursing Facility |
| (1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis. |
| Notes: Source: (1) "Glossary of terms used in managed care" Developed by the Managed Care Assembly (MCA) of Medical Group Management Association (MGMA), MGM Journal, September/October 1995, p. 64; (2) AHA Guide, 1996 Annual Survey. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013434703 | Snf Lincoln Operating Company LLC | Skilled Nursing Facility | 5431 S 16th St, Lincoln, NE 68512-1206 | 2017-08-24 |
| 1518491976 | Hillcrest Firethorn, LLC | Skilled Nursing Facility | 8601 Firethorn Lane, Lincoln, NE 68520 | 2017-04-12 |
| 1710359161 | Bsl- Bn Commons Snf Operator LLC | Skilled Nursing Facility | 3 Harvest Cir, Lincoln, MA 01773-3214 | 2015-10-26 |
| 1437546033 | Tabitha Inc | Skilled Nursing Facility | 3355 Orwell St, Lincoln, NE 68516-6624 | 2015-04-21 |
| 1205226552 | Bonnilee Anne Tyrrell | Skilled Nursing Facility | 7208 Van Dorn St, Lincoln, NE 68506-3651 | 2015-01-26 |
| 1073902128 | Laci Harper | Skilled Nursing Facility | 4800 Lonewood Dr, Lincoln, NE 68516-1464 | 2015-01-13 |
| 1477965234 | Amanda Stamm | Skilled Nursing Facility | 6040 S 58th St Ste C, Lincoln, NE 68516-3695 | 2014-05-28 |
| 1699100214 | Tabitha Inc | Skilled Nursing Facility | 6120 South 34th Street, Lincoln, NE 68516 | 2013-09-13 |
| 1306174990 | Autumn Research | Skilled Nursing Facility | 5b S Commons, Lincoln, MA 01773-1114 | 2009-11-19 |
| 1740432517 | Kimberly Lizotte | Skilled Nursing Facility | 642 River Rd, Lincoln, RI 02865-1406 | 2008-10-10 |
| Find all providers in LINCOLN | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.