NPIMap

Organization Active NPI

Covenant Home, Inc. (Connecticut)

Doing business as Pilgrim Manor

  • Skilled Nursing Facility
  • Cromwell, CT
National Provider Identifier
1851497093
Registry record updated Sep 6, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
COVENANT HOME, INC. (CONNECTICUT)
Doing business as
Pilgrim Manor
Practice address
52 Missionary Road
Cromwell, CT 06416
Phone
(860) 635-2690
Fax
(860) 632-2407
NPI assigned
Sep 15, 2006
Last updated
Sep 6, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 6, 2016

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

Authorized official

Name
Elizabeth Malzahn
Title
Vice President of Health Services
Phone
(773) 878-4430

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 966-C CT
Skilled Nursing Facility 314000000X CT Primary

Addresses

Primary practice location

52 Missionary Road
Cromwell, CT 06416

Mailing address

52 Missionary Road
Cromwell, CT 06416
Phone (860) 635-2690

Other identifiers 3

IdentifierTypeStateIssuer
000007260MedicaidCT
0092064OtherCTICF MEDICAID
0092064MedicaidCT

Other names 1

  • Pilgrim Manor Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090921000634 CT Part A Provider - Skilled Nursing Facility 8426104167 Practice locations: Cromwell, CT

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1851497093. Details of each certification follow.

Skilled nursing facility certification: CCN 075306

Legal name
COVENANT HOME, INC. CONNECTICUT
Doing business as
PILGRIM MANOR
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Feb 1, 1987
Last certification
Apr 23, 2024
Beds
60
Ownership / control type
Nonprofit Corporation
Multi-facility organization
COVENANT LIVING COMMUNITIES E SERVICES
Organization structure
CorporationNon-profit
Incorporated
Mar 19, 1962 in CT
Enrollment address
52 Missionary Rd
Cromwell, CT 06416-2143
Nursing home name
PILGRIM MANOR
Affiliated entity
COVENANT LIVING

Care Compare: Nursing home

Medicare Care Compare
Listed as
Pilgrim ManorCCN 075306 · All quality measures
Overall star rating
5 of 5
Health inspections
4 of 5
Staffing
5 of 5
Quality measures
5 of 5
Type
Medicare and Medicaid
Ownership
Non profit - Corporation
Certified
Feb 1, 1987
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
6054.3 residents per day on average
Chain
Covenant Living15 facilities in the chain
Penalties (3 years)
1Fines totaling $12,048

Processed by Care Compare on Aug 1, 2026.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
07D0096218Pilgrim Manor52 Missionary Road, Cromwell, CT 06416Certificate of waiverAug 31, 2026

National Provider Directory

National Provider Directory

Locations

52 Missionary Rd
Cromwell, CT 06416
Phone (860) 635-2690

Ownership & related parties

All disclosed owners & managing parties 13

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Marc E Espinosa Individual Corporate DirectorBoard Member Jul 1, 2013
Donald Hodgkinson Individual Corporate DirectorBoard Member Jul 1, 2013
Pamela Christensen Individual Corporate DirectorBoard Member Jul 1, 2013
Covenant Living Communities & Services Organization, Skokie, IL Non-profit 5% Or Greater Direct Ownership Interest Jan 3, 2014 100%
Operational/Managerial Control Jan 3, 2014 100%
Roger Oxendale Individual Corporate DirectorBoard Member Jul 1, 2017
Anne E Vining Individual Corporate DirectorBoard Member Jul 1, 2013
David Erickson Individual Corporate OfficerSenior Vice President Jan 31, 2008
Marlene E Stante Individual Corporate DirectorBoard Member Jul 1, 2013
Terri Cunliffe Individual Corporate OfficerCeo Mar 19, 2009
W-2 Managing EmployeeSenior VP Mar 19, 2009
Jon P Aagaard Individual Corporate DirectorBoard Member Jul 1, 2013
Mark C Eastburg Individual Corporate DirectorBoard Member Jul 1, 2013
Matt Manlove Individual Corporate DirectorBoard Member Jul 1, 2017
Jody Holt Individual Corporate OfficerCfo Jun 2, 2017
W-2 Managing EmployeeCfo Jun 2, 2017
Operational/Managerial ControlBoard Member Jul 1, 2013

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Facilities with the same owner 16

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 16

Practitioners & affiliated clinicians

Affiliated clinicians 4

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1158278400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1473120000000",
    "number": "1851497093",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "52 MISSIONARY ROAD",
            "city": "CROMWELL",
            "state": "CT",
            "postal_code": "06416",
            "telephone_number": "860-635-2690",
            "fax_number": "860-632-2407"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "52 MISSIONARY ROAD",
            "city": "CROMWELL",
            "state": "CT",
            "postal_code": "06416",
            "telephone_number": "860-635-2690",
            "fax_number": "860-632-2407"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COVENANT HOME, INC. (CONNECTICUT)",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-15",
        "last_updated": "2016-09-06",
        "status": "A",
        "authorized_official_last_name": "MALZAHN",
        "authorized_official_first_name": "ELIZABETH",
        "authorized_official_title_or_position": "VICE PRESIDENT OF HEALTH SERVICES",
        "authorized_official_telephone_number": "773-878-4430"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "CT",
            "license": "966-C",
            "primary": false
        },
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "CT",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000007260",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ICF MEDICAID",
            "identifier": "0092064",
            "state": "CT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0092064",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pilgrim Manor",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Cromwell, CT

Sources for this page

Verify at the official NPI Registry.