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Organization
COLONIAL MANOR GUEST HOUSE, LLC
Active
Organization
COLONIAL MANOR GUEST HOUSE, LLC
Active
Other names
Colonial Manor Guest House
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TEDDY RAY PRICE (MANAGING MEMBER)
(318) 628-4116
Entity
Organization
Contact information
Practice address
114 WHATLEY ST, RAYVILLE, LA 71269-3318
(318) 728-3252
(318) 728-6552
Mailing address
PO BOX 874, RAYVILLE, LA 71269-0874
(318) 728-3252
(318) 728-6552
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
233
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1517151
—
LA
Enumeration date
11/07/2005
Last updated
08/22/2020
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