- Enrollment id
- O20220510000746
- Enrollment state
- NJ
- Provider type code
- 00-18
- Provider type text
- PART A PROVIDER - SKILLED NURSING FACILITY
- Npi
- 1033878590
- Multiple npi flag
- N
- Ccn
- 315305
- Associate id
- 0345637773
- Organization name
- SPRING CREEK REHABILITATION AND NURSING CENTER LLC
- Doing business as name
- SPRING CREEK HEALTHCARE CENTER
- Incorporation date
- 2021-05-10
- Incorporation state
- NJ
- Organization type structure
- LLC
- Proprietary nonprofit
- P
- Nursing home provider name
- SPRING CREEK HEALTHCARE CENTER
- Affiliation entity name
- ALLAIRE HEALTH SERVICES
- Affiliation entity id
- 21
- Address line 1
- 1 LINDBERGH AVE
- City
- PERTH AMBOY
- State
- NJ
- Zip code
- 088611841