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Organization

COLONIAL MANOR NURSING HOME

Active
Organization subpart
No

Provider details

NPI number
Authorized official
BILL O'CONNOR (BOARD PRESIDENT)
(507) 662-6646
Entity
Organization

Contact information

Practice address
403 COLONIAL AVE, LAKEFIELD, MN 56150-9573
(507) 662-6646
(507) 662-5531
Mailing address
403 COLONIAL AVE, LAKEFIELD, MN 56150-9573
(507) 662-6646
(507) 662-5531

Taxonomy

Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
331921
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
9471CO
BCBS PROVIDER NUMBER
MN
01
NH0230
UCARE PROVIDER NUMBER
MN
Enumeration date
06/03/2006
Last updated
09/19/2007
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