Provider Demographics
NPI:1326151804
Name:SPRING CREEK MANAGEMENT, LP
Entity Type:Organization
Organization Name:SPRING CREEK MANAGEMENT, LP
Other - Org Name:SPRING CREEK REHABILITATION AND HEALTH CARE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF OPERATING OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:CLAYTON
Authorized Official - Middle Name:HOLBROOK
Authorized Official - Last Name:CHRISTENSEN
Authorized Official - Suffix:
Authorized Official - Credentials:NHA
Authorized Official - Phone:203-227-1763
Mailing Address - Street 1:1205 S 28TH ST
Mailing Address - Street 2:
Mailing Address - City:HARRISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17111-1046
Mailing Address - Country:US
Mailing Address - Phone:717-558-1000
Mailing Address - Fax:717-558-8658
Practice Address - Street 1:1205 S 28TH ST
Practice Address - Street 2:
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17111-1046
Practice Address - Country:US
Practice Address - Phone:717-558-1000
Practice Address - Fax:717-558-8658
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-17
Last Update Date:2008-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAIN PROCESS OF OBTAIN314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1017950190001Medicaid
PA1326151804Medicare Oscar/Certification