Organization
COLONIAL MANOR-MCALLEN, L.P.
Active
Other names
Colonial Manor
Organization subpart
No
Provider details
NPI number
Authorized official
MR. PETER J LICARI (PRESIDENT OF GENERAL PARTNER)
(215) 441-7700
Entity
Organization
Contact information
Practice address
209 W. HACKBERRY AVENUE, MCALLEN, TX 78501-2559
(956) 686-2243
(956) 686-0209
Mailing address
200 DRYDEN ROAD, SUITE 2000, DRESHER, PA 19025
(215) 441-7700
(215) 441-4255
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
114556
TX
332BN1400X
Nursing Facility Supplies (DME)
114556
TX
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
114556
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004547
—
TX
Enumeration date
10/14/2005
Last updated
11/14/2007
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