Organization
COLONIAL MANOR OF ELMA INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TIMOTHY ROBERTS (CFO)
(641) 456-5636
Entity
Organization
Contact information
Practice address
407 9TH ST, ELMA, IA 50628-8217
(641) 393-2134
(641) 393-2004
Mailing address
1320 4TH ST NE, HAMPTON, IA 50441-1104
(641) 456-5636
(641) 456-2320
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
—
—
261QA0600X
Adult Day Care Clinic/Center
—
—
314000000X
Skilled Nursing Facility
Primary
450794
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0800722
—
IA
01
—
65386
WELLMARK
IA
Enumeration date
08/12/2005
Last updated
01/05/2024
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