Provider Demographics
NPI:1164642781
Name:HIGHLAND VIEW MANOR INC
Entity Type:Organization
Organization Name:HIGHLAND VIEW MANOR INC
Other - Org Name:LITCHFIELD WOODS HEALTHCARE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:MOSIER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:860-751-3900
Mailing Address - Street 1:255 ROBERTS ST
Mailing Address - Street 2:
Mailing Address - City:TORRINGTON
Mailing Address - State:CT
Mailing Address - Zip Code:06790-4744
Mailing Address - Country:US
Mailing Address - Phone:860-489-5801
Mailing Address - Fax:
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:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ATHENA HEALTH CARE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-04-26
Last Update Date:2015-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT2034C313M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes313M00000XNursing & Custodial Care FacilitiesNursing Facility/Intermediate Care Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT000095077Medicaid