Healthcare Provider Details

I. General information

NPI: 1184729485
Provider Name (Legal Business Name): VALERIE MANOR INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/13/2006
Last Update Date: 02/16/2023
Certification Date: 02/16/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1360 TORRINGFORD ST
TORRINGTON CT
06790-3140
US

IV. Provider business mailing address

1360 TORRINGFORD ST
TORRINGTON CT
06790-3140
US

V. Phone/Fax

Practice location:
  • Phone: 860-489-1008
  • Fax: 860-482-4266
Mailing address:
  • Phone: 860-489-1008
  • Fax: 860-482-4266

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number1070-C
License Number StateCT

VIII. Authorized Official

Name: LAWRENCE G. SANTILLI
Title or Position: PRESIDENT/CEO
Credential:
Phone: 860-751-3900