Organization
COLONIAL LONG TERM CARE FACILITY, INC
Active
Organization
COLONIAL LONG TERM CARE FACILITY, INC
Active
Other names
Colonial Care, Inc
Organization subpart
No
Provider details
NPI number
Authorized official
MARK A. PAYNE (ADMINISTRATOR)
(336) 786-2194
Entity
Organization
Contact information
Practice address
340 SNOWHILL DR, MOUNT AIRY, NC 27030-4394
(336) 786-2194
(336) 786-8891
Mailing address
340 SNOWHILL DR, MOUNT AIRY, NC 27030-4394
(336) 786-2194
(336) 786-8891
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
HAL-086-002
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7801494
—
NC
Enumeration date
01/18/2007
Last updated
08/20/2010
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