Crescent Manor Rest Home, Inc

Primary specialty

Custodial Care FacilityTaxonomy code 311Z00000X

License

851 Issued in MA

Legal business name

CRESCENT MANOR REST HOME, INC

Practice address

5 Crescent St
Grafton, MA 01519-1221

Phone

(508) 839-2124

Fax

(508) 839-4773

NPI assigned

Sep 8, 2005

Organization subpart

No

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

Authorized official

Name

Mr. Glen S Brewer

Title

Treasurer

Phone

(508) 839-2124

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1126137600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1871587576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 CRESCENT ST",
            "city": "GRAFTON",
            "state": "MA",
            "postal_code": "015191221",
            "telephone_number": "508-839-2124",
            "fax_number": "508-839-4773"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 CRESCENT ST",
            "city": "GRAFTON",
            "state": "MA",
            "postal_code": "015191221",
            "telephone_number": "508-839-2124",
            "fax_number": "508-839-4773"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CRESCENT MANOR REST HOME, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-08",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BREWER",
        "authorized_official_first_name": "GLEN",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "TREASURER",
        "authorized_official_telephone_number": "508-839-2124",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "311Z00000X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility",
            "state": "MA",
            "license": "851",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• CG Wellness LLC
• Farai Linda Chikove, RN
• Clarity Counseling, LLM
• Commonwealth Autism Services LLC
• Crescent Manor Assisted Care LLC
• Victoria Cruz, LMHC
• Kerri A Ellis, NP
• Telana Nicole Fairchild, FNP
• Forever Care Home Services
• Donna L Forti, LIC. AC.

• Custodial Care Facility in Grafton, MA
• Providers in Grafton, MA by specialty
• Custodial Care Facility in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.