MEDICARE: HEALTH CARE VENTURES INC DBA CRESCENT MANOR

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	314000000X	Skilled Nursing Facility	2156C	CT

General Provider Information

NPI Number	:	1962405720
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HEALTH CARE VENTURES INC DBA CRESCENT MANOR

Provider Business Mailing Address
First Line	:	1157 HIGHLAND AVE
Second Line	:	STE 102
City	:	CHESHIRE
State	:	CT
Zip	:	06410-1600
Country	:	US
Telephone Number	:	203-250-2030
Fax Number	:	203-250-2034

Provider Business Practice Location Address
First Line	:	1243 W MAIN ST
Second Line	:
City	:	WATERBURY
State	:	CT
Zip	:	06708-3101
Country	:	US
Telephone Number	:	203-757-0561
Fax Number	:	203-755-5998

Authorized Official
Title or Position	:	CONTROLLER
Name	:	MS. GLADYS HARRISON
Credential	:
Telephone Number	:	203-250-2030

Provider Enumeration Date	:	05/24/2005
Last Update Date	:	08/22/2020

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