Healthcare Provider Details

I. General information

NPI: 1215811872
Provider Name (Legal Business Name): CIRRUS MANOR RESIDENTIAL CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/05/2025
Last Update Date: 06/23/2026
Certification Date: 06/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2515 CULVER RD
ROCHESTER NY
14609-1751
US

IV. Provider business mailing address

2515 CULVER RD
ROCHESTER NY
14609-1751
US

V. Phone/Fax

Practice location:
  • Phone: 917-544-4713
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number State

VIII. Authorized Official

Name: MR. AVI LUSTIG
Title or Position: OWNER
Credential:
Phone: 917-544-4713