Organization
COLONIAL MANORS OF FAYETTE, INC
Active
Other names
Maple Crest Manor & Assisted Living
Organization subpart
No
Provider details
NPI number
Authorized official
DEBRA J HELDT (NURSING HOME ADMINISTRATOR)
(563) 425-3336
Entity
Organization
Contact information
Practice address
100 BOLGER DR, FAYETTE, IA 52142-9762
(563) 425-3336
(563) 425-3512
Mailing address
100 BOLGER DR, FAYETTE, IA 52142-9762
(563) 425-3336
(563) 425-3512
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
S0204
IA
314000000X
Skilled Nursing Facility
Primary
330221
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0802470
—
IA
Enumeration date
08/24/2005
Last updated
09/14/2011
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