Organization
COLONIAL HOUSE I LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RAQUEL EDERY (COO)
(516) 708-3503
Entity
Organization
Contact information
Practice address
1516 HIGHWAY 44 E, SHEPHERDSVILLE, KY 40165-7182
(502) 883-9113
Mailing address
455 CENTRAL AVE STE 215, CEDARHURST, NY 11516-2008
(516) 708-3503
Taxonomy
Speciality
Code
Description
License number
State
3104A0625X
Assisted Living Facility (Mental Illness)
Primary
—
—
Other
Enumeration date
01/30/2025
Last updated
01/30/2025
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