Provider Demographics
NPI:1770641490
Name:STERLING MANOR, INC.
Entity Type:Organization
Organization Name:STERLING MANOR, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:ULATOWSKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:860-289-9571
Mailing Address - Street 1:870 BURNSIDE AVE
Mailing Address - Street 2:
Mailing Address - City:EAST HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06108-2711
Mailing Address - Country:US
Mailing Address - Phone:802-295-9531
Mailing Address - Fax:860-289-8348
Practice Address - Street 1:870 BURNSIDE AVE
Practice Address - Street 2:
Practice Address - City:EAST HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06108-2711
Practice Address - Country:US
Practice Address - Phone:802-295-9531
Practice Address - Fax:860-289-8348
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT2070C314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT075229Medicare ID - Type Unspecified