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NPI Code Detail

MEDICARE: SPRING CREEK REHAB LLC

MEDICARE: SPRING CREEK REHAB LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1314000000XSkilled Nursing Facility

General Provider Information

NPI Number : 1912614231
Entity Type Code : Organization
Provider Name (Legal Business Name) : SPRING CREEK REHAB LLC
Provider Business Mailing Address
First Line : 51 VIRGINIA AVE
Second Line :
City : CLIFTON
State : NJ
Zip : 07012-1222
Country : US
Telephone Number : 917-613-4386
Fax Number :
Provider Business Practice Location Address
First Line : 1401 S 16TH ST
Second Line :
City : MURRAY
State : KY
Zip : 42071-2804
Country : US
Telephone Number : 270-752-2900
Fax Number :
Authorized Official
Title or Position : AUTHORIZED SIGNATORY
Name : NAFTALI WEISS
Credential :
Telephone Number : 917-613-4386
Provider Enumeration Date : 11/07/2022
Last Update Date : 11/07/2022

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Directions to “SPRING CREEK REHAB LLC ” Practice Location

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