Organization
COLONIAL MANOR LTC, LLC
Active
Other names
Colonial Nursing Center
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL P SLYK PHARMD FASCP (PRESIDENT)
(330) 424-3721
Entity
Organization
Contact information
Practice address
1528 MARKET AVE N, CANTON, OH 44714-2695
(330) 453-8466
(330) 453-1424
Mailing address
1528 MARKET AVE N, CANTON, OH 44714-2695
(330) 453-8466
(330) 453-1424
Taxonomy
Speciality
Code
Description
License number
State
313M00000X
Nursing Facility/Intermediate Care Facility
3620
OH
314000000X
Skilled Nursing Facility
Primary
3620
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0177544
—
OH
05
—
2635938
—
OH
Enumeration date
10/21/2005
Last updated
09/11/2025
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