Provider Demographics
NPI:1386312213
Name:COUNTRY CREEK AFC, INC.
Entity type:Organization
Organization Name:COUNTRY CREEK AFC, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MEAGHAN
Authorized Official - Middle Name:
Authorized Official - Last Name:RINALDI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:517-676-1070
Mailing Address - Street 1:1600 E GRAND RIVER AVE
Mailing Address - Street 2:
Mailing Address - City:EAST LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48823-4909
Mailing Address - Country:US
Mailing Address - Phone:517-676-1070
Mailing Address - Fax:
Practice Address - Street 1:2771 LAMB RD
Practice Address - Street 2:
Practice Address - City:MASON
Practice Address - State:MI
Practice Address - Zip Code:48854-9316
Practice Address - Country:US
Practice Address - Phone:517-676-1070
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:EMMAUS CORPORATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-09-03
Last Update Date:2021-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253J00000XAgenciesFoster Care Agency