# AVENUE H, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Creekside Care Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1275928707
- **Authorized official:** STEVEN R POWELL (PRESIDENT)
- **Authorized official phone:** (909) 457-2977

## Contact information

- **Practice address:** 35253 AVENUE H, YUCAIPA, CA 92399-5396
- **Practice address phone:** (909) 795-2476
- **Practice address fax:** (909) 795-0458
- **Mailing address:** 35253 AVENUE H, YUCAIPA, CA 92399-5415
- **Mailing address phone:** (909) 795-2476
- **Mailing address fax:** (909) 795-0458

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | 240000224 | CA | Yes |

## Other

- **Enumeration date:** 04/01/2015
- **Last updated:** 12/02/2022