Organization
COLONIAL RETIREMENT CENTER INC.
Active
Other names
Colonial Residential Care Facility II
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RONALD LYNN CONWAY (ADMINISTRATOR)
(573) 734-2846
Entity
Organization
Contact information
Practice address
1162 CEDAR STREET, BISMARCK, MO 63624-0727
(573) 734-2846
(573) 734-2008
Mailing address
1162 CEDAR STREET, P.O.BOX 727, BISMARCK, MO 63624-0727
(573) 734-2846
(573) 734-2008
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
032375
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2667449911
—
MS
Enumeration date
03/02/2007
Last updated
08/22/2020
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