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Organization
MILLCREEK MANOR
Active
Organization
MILLCREEK MANOR
Active
Other names
LECOM Home Care
Organization subpart
No
Provider details
NPI number
Authorized official
ERICA DEMAURI (CONTROLLER)
(814) 868-2496
Entity
Organization
Contact information
Practice address
3910 SCHAPER AVE, ERIE, PA 16508-3346
(814) 453-5072
(814) 452-1578
Mailing address
5535 PEACH ST, ERIE, PA 16509-2603
(814) 453-5072
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0012079290005
—
PA
Enumeration date
01/30/2020
Last updated
01/30/2020
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