Organization
MILLCREEK MANOR
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RICHARD OLINGER (CHIEF FINANCIAL OFFICER)
(814) 868-8167
Entity
Organization
Contact information
Practice address
5515 PEACH ST, ERIE, PA 16509-2603
(814) 868-7395
Mailing address
5515 PEACH ST, ERIE, PA 16509-2603
(814) 868-7395
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
131102
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0012079290002
—
PA
Enumeration date
06/13/2005
Last updated
08/22/2020
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