| NPI | 1487601704 |
|---|---|
| Doing Business As | CREEKSIDE CENTER |
| Entity Type | Organization |
| Authorized Contact | MICHAEL T. BERG Assistant Secretary 505-468-4752 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 314000000X Skilled Nursing Facility (Licence: CA 100000358) |
| Enumeration Date | 2006-05-30 |
| Last Update Date | 2016-04-19 |