Provider Demographics
NPI:1992890032
Name:HIGHLAND VIEW MANOR INC
Entity type:Organization
Organization Name:HIGHLAND VIEW MANOR INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:
Authorized Official - First Name:LAWRENCE
Authorized Official - Middle Name:G
Authorized Official - Last Name:SANTILLI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:860-751-3900
Mailing Address - Street 1:255 ROBERTS STREET
Mailing Address - Street 2:
Mailing Address - City:TORRINGTON
Mailing Address - State:CT
Mailing Address - Zip Code:06790
Mailing Address - Country:US
Mailing Address - Phone:860-489-5801
Mailing Address - Fax:860-489-6102
Practice Address - Street 1:255 ROBERTS ST
Practice Address - Street 2:
Practice Address - City:TORRINGTON
Practice Address - State:CT
Practice Address - Zip Code:06790-4744
Practice Address - Country:US
Practice Address - Phone:860-489-5801
Practice Address - Fax:860-489-6102
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ATHENA HEALTH CARE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-10-04
Last Update Date:2023-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT2034C314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
049090OtherCONNECTICARE
CT000020347Medicaid
890OtherB CROSS
CT000020347Medicaid