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Organization
COLONIAL PARK NURSING HOME INC
Active
Organization
COLONIAL PARK NURSING HOME INC
Active
Other names
COLONIAL PARK NURSING HOME
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHN SMART (PRESIDENT)
(405) 380-6902
Entity
Organization
Contact information
Practice address
600 W FRONTAGE RD, OKEMAH, OK 74859-6433
(918) 623-1936
(918) 623-2287
Mailing address
131 N BROADWAY AVE, ADA, OK 74820-5003
(580) 436-0950
(580) 436-0953
Taxonomy
Speciality
Code
Description
License number
State
313M00000X
Nursing Facility/Intermediate Care Facility
NH5405-5405
OK
314000000X
Skilled Nursing Facility
Primary
NH5405-5405
OK
Other
Enumeration date
03/08/2011
Last updated
03/08/2011
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