Health Care Reliance LLC D/B/a Ellis Manor

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

2187C Issued in CT

Legal business name

HEALTH CARE RELIANCE LLC D/B/A ELLIS MANOR

Practice address

210 George St
Hartford, CT 06114-2823

Phone

(860) 296-9166

Fax

(860) 296-8020

NPI assigned

May 24, 2005

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ms. Gladys Harrison

Title

Controller

Phone

(203) 250-2030

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• ELLIS MANOR Doing business as

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1116892800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1218067200000",
    "number": "1447253281",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1157 HIGHLAND AVE",
            "address_2": "STE 102",
            "city": "CHESHIRE",
            "state": "CT",
            "postal_code": "064101600",
            "telephone_number": "203-250-2030",
            "fax_number": "203-250-2034"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 GEORGE ST",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "061142823",
            "telephone_number": "860-296-9166",
            "fax_number": "860-296-8020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALTH CARE RELIANCE LLC D/B/A ELLIS MANOR",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-05-24",
        "last_updated": "2008-08-07",
        "status": "A",
        "authorized_official_last_name": "HARRISON",
        "authorized_official_first_name": "GLADYS",
        "authorized_official_title_or_position": "CONTROLLER",
        "authorized_official_telephone_number": "203-250-2030",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "CT",
            "license": "2187C",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000010595",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ELLIS MANOR",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Skilled Nursing Facility in Hartford, CT
• Providers in Hartford, CT by specialty
• Skilled Nursing Facility in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.