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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