Provider Demographics
NPI:1376951202
Name:MILL CREEK SERIVCES, INC.
Entity Type:Organization
Organization Name:MILL CREEK SERIVCES, INC.
Other - Org Name:GRISWOLD HOME CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:VANESSA
Authorized Official - Middle Name:
Authorized Official - Last Name:RICE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:856-692-8765
Mailing Address - Street 1:10 S WEST AVE
Mailing Address - Street 2:
Mailing Address - City:VINELAND
Mailing Address - State:NJ
Mailing Address - Zip Code:08360-4543
Mailing Address - Country:US
Mailing Address - Phone:856-692-8765
Mailing Address - Fax:877-737-7030
Practice Address - Street 1:10 S WEST AVE
Practice Address - Street 2:
Practice Address - City:VINELAND
Practice Address - State:NJ
Practice Address - Zip Code:08360-4543
Practice Address - Country:US
Practice Address - Phone:856-692-8765
Practice Address - Fax:877-737-7030
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-23
Last Update Date:2014-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJHP0051200253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care