Organization
VILLAGE MANOR INC BANKRUPTCY
Active
Other names
VILLAGE MANOR INC BANKRUPTCY
Organization subpart
No
Provider details
NPI number
Authorized official
TIMOTHY JOHN COBURN (ADMINISTRATOR/MANAGER)
(860) 564-4081
Entity
Organization
Contact information
Practice address
16 WINDSOR AVENUE, PLAINFIELD, CT 06374
(860) 564-4081
(860) 564-1472
Mailing address
16 WINDSOR AVENUE, PLAINFIELD, CT 06374
(860) 564-4081
(860) 564-1472
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
2003-C
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
#20032
—
CT
05
—
000020032
—
CT
Enumeration date
04/14/2006
Last updated
01/13/2011
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