Healthcare Provider Details

I. General information

NPI: 1457970816
Provider Name (Legal Business Name): VALERIE MANOR INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/15/2020
Last Update Date: 04/15/2020
Certification Date: 04/15/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

225 WYOMING AVE
TORRINGTON CT
06790-6043
US

IV. Provider business mailing address

1360 TORRINGFORD ST
TORRINGTON CT
06790-3140
US

V. Phone/Fax

Practice location:
  • Phone: 860-618-9066
  • Fax:
Mailing address:
  • Phone: 860-489-1008
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

Name: MICHAEL MOSIER
Title or Position: CFO
Credential:
Phone: 860-751-3900