Organization
HICKORY CREEK HOME CARE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JILL COREY (COO)
(814) 866-2919
Entity
Organization
Contact information
Practice address
315 2ND AVE STE 311, WARREN, PA 16365-2433
(814) 406-9921
Mailing address
315 2ND AVE STE 311, WARREN, PA 16365-2433
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1031027870001
—
PA
Enumeration date
05/31/2019
Last updated
05/31/2019
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