Organization
CSR CORP
Active
Other names
Crescent Manor Care Ctr
Organization subpart
No
Provider details
NPI number
Authorized official
CLAUDETTE WERNER POORMAN (ADMINISTRATOR)
(802) 447-1501
Entity
Organization
Contact information
Practice address
312 CRESCENT BLVD, BENNINGTON, VT 05201
(802) 447-1501
(802) 442-7127
Mailing address
312 CRESCENT BLVD, BENNINGTON, VT 05201
(802) 447-1501
(802) 442-7127
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
0270000270
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01014828
—
NY
05
—
0475033
—
VT
Enumeration date
02/23/2006
Last updated
08/22/2020
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