# COLONIAL MANOR MANAGEMENT COMPANY, L.L.C.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1225170467
- **Authorized official:** MR. ED RUCKER (ADMINISTRATOR)
- **Authorized official phone:** (918) 743-7838

## Contact information

- **Practice address:** 1815 E SKELLY DR, TULSA, OK 74105-5919
- **Practice address phone:** (918) 743-7838
- **Practice address fax:** (918) 748-5970
- **Mailing address:** 1815 E SKELLY DR, TULSA, OK 74105-5919
- **Mailing address phone:** (918) 743-7838
- **Mailing address fax:** (918) 748-5970

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | NH7208-7208 | OK | Yes |

## Other

- **Enumeration date:** 02/13/2007
- **Last updated:** 05/18/2011

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 200119130A | — | OK |