Organization
COLONIAL MANOR OF ELMA
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) 393-2125
Mailing address
1320 4TH ST NE, HAMPTON, IA 50441-1104
(641) 456-5636
(641) 456-2320
Taxonomy
Speciality
Code
Description
License number
State
261QR0400X
Rehabilitation Clinic/Center
Primary
—
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0653865
—
IA
Enumeration date
10/09/2008
Last updated
10/18/2010
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