Provider Demographics
NPI:1750518817
Name:MORGAN CREEK THERAPIES, LLC
Entity type:Organization
Organization Name:MORGAN CREEK THERAPIES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GABRIELE
Authorized Official - Middle Name:LUCK
Authorized Official - Last Name:MELVILLE
Authorized Official - Suffix:
Authorized Official - Credentials:OT/L, CLT-LANA
Authorized Official - Phone:919-619-3490
Mailing Address - Street 1:1000 DAIRYLAND RD
Mailing Address - Street 2:
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27516-5640
Mailing Address - Country:US
Mailing Address - Phone:919-933-5068
Mailing Address - Fax:
Practice Address - Street 1:1829 E FRANKLIN ST STE 200A
Practice Address - Street 2:
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27514-1866
Practice Address - Country:US
Practice Address - Phone:919-619-3490
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-16
Last Update Date:2009-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3074261QR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation