Organization
NICE AVENUE LLC
Active
Other names
Mill Creek Manor
Organization subpart
No
Provider details
NPI number
Authorized official
STEVEN R. POWELL (PRESIDENT)
(909) 457-2977
Entity
Organization
Contact information
Practice address
2278 NICE AVE, MENTONE, CA 92359-9655
(909) 794-1189
Mailing address
2278 NICE AVE, MENTONE, CA 92359-9655
(909) 794-1189
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
CA
Other
Enumeration date
04/17/2015
Last updated
12/02/2022
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