OrganizationActive
Maple Lake Assisted Living
NPI 1306279740 · Exclusive Provider Organization · Paw Paw, MI
Provider details
- NPI number
- 1306279740
- Entity type
- Organization
- Primary specialty
- Exclusive Provider OrganizationManaged Care Organizations
- Parent organization
- Leisure Living Management
- Organization subpart
- Yes
- Authorized official
- Lindsey Haley, Director of Operations(616) 901-2986
- License
- AH800315846 (MI)
Specialties & taxonomies
Managed Care Organizations
Practice location
677 Hazen St
Paw Paw, MI 49079-1010
Phone: (269) 657-0190
Fax: (269) 657-4290
Approximate (ZIP-level) locationGet directions
Mailing address
3196 Kraft Ave Se
Grand Rapids, MI 49512-2078
Registry dates
- Enumerated
- 2013-08-20
- Last updated
- 2013-08-20
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.