# CREEKSIDE HEALTHCARE, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Creekside Health and Rehabilitation Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1104250406
- **Authorized official:** MR. JOHN J SHEEHAN JR. (PRESIDENT)
- **Authorized official phone:** (423) 618-1488

## Contact information

- **Practice address:** 306 W DUE WEST AVE, MADISON, TN 37115-4511
- **Practice address phone:** (615) 612-4499
- **Practice address fax:** (615) 612-4498
- **Mailing address:** 306 W DUE WEST AVE, MADISON, TN 37115-4511
- **Mailing address phone:** (615) 612-4499
- **Mailing address fax:** (615) 612-4498

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | — | NULL | Yes |

## Other

- **Enumeration date:** 08/23/2013
- **Last updated:** 02/28/2014