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General NPI Number Information
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NPI Number | 1447253281
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Entity Type | Organization
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Legal Business Name | HEALTH CARE RELIANCE LLC D/B/A ELLIS MANOR
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Dates
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Enumeration Date | 05/24/2005
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Last Update Date | 08/07/2008
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Provider Practice Location Address
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Address Line | 210 GEORGE ST
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City | HARTFORD
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State | CT
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Zip | 06114-2823
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Country | US
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Telephone | 860-296-9166
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Fax | 860-296-8020
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Provider Business Mailing Address
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Address Line | 1157 HIGHLAND AVE STE 102
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City | CHESHIRE
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State | CT
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Zip | 06410-1600
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Country | US
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Telephone | 203-250-2030
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Fax | 203-250-2034
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Authorized Official
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Title or Position | CONTROLLER
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Name | MS. GLADYS HARRISON
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Credential |
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Telephone | 203-250-2030
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number | 2187C
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License Number State | CT
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