Organization
MILLCREEK MANOR
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEANNE L MILLER (PT ACCT MGR)
(814) 868-8252
Entity
Organization
Contact information
Practice address
5515 PEACH ST, ERIE, PA 16509-2603
(814) 868-8252
Mailing address
5515 PEACH ST, ERIE, PA 16509-2603
(814) 868-8252
Taxonomy
Speciality
Code
Description
License number
State
313M00000X
Nursing Facility/Intermediate Care Facility
Primary
123456
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2144
HIGHMARK
PA
Enumeration date
01/05/2007
Last updated
08/22/2020
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