Provider Demographics
NPI:1144421496
Name:MILLCREEK SCHOOLS, LLC
Entity Type:Organization
Organization Name:MILLCREEK SCHOOLS, LLC
Other - Org Name:MILLCREEK OF PONTOTOC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VP & TREASURER
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:
Authorized Official - Last Name:HOWARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-861-6000
Mailing Address - Street 1:6100 TOWER CIR STE 1000
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37067-1509
Mailing Address - Country:US
Mailing Address - Phone:615-861-6000
Mailing Address - Fax:
Practice Address - Street 1:1814 HWY 15 NORTH
Practice Address - Street 2:
Practice Address - City:PONTOTOC
Practice Address - State:MS
Practice Address - Zip Code:38863
Practice Address - Country:US
Practice Address - Phone:662-488-8878
Practice Address - Fax:662-488-8767
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-31
Last Update Date:2018-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes323P00000XResidential Treatment FacilitiesPsychiatric Residential Treatment Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS05475076Medicaid