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NPI Code Detail

MEDICARE: SPRING CREEK KY OPCO LLC

MEDICARE: SPRING CREEK KY OPCO 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 : 1700462363
Entity Type Code : Organization
Provider Name (Legal Business Name) : SPRING CREEK KY OPCO LLC
Provider Business Mailing Address
First Line : 1449 37TH ST STE 605
Second Line :
City : BROOKLYN
State : NY
Zip : 11218-4382
Country : US
Telephone Number : 646-649-0478
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 : MANAGER
Name : ISAAC MOSKOWITZ
Credential :
Telephone Number : 212-444-1991
Provider Enumeration Date : 03/23/2021
Last Update Date : 02/07/2023

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Directions to “SPRING CREEK KY OPCO LLC ” Practice Location

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