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Organization

COLONIAL PLAZA NURSING HOME INC

Active
Other names
Linwood Village Nursing & Retirement Apartments
Organization subpart
No

Provider details

NPI number
Authorized official
ED RUCKER (ADMISTRATOR)
(918) 743-7838
Entity
Organization

Contact information

Practice address
530 S LINWOOD AVE, CUSHING, OK 74023-4644
(918) 743-7838
Mailing address
530 S LINWOOD AVE, CUSHING, OK 74023-4644
(918) 743-7838

Taxonomy

Speciality
Code
Description
License number
State
313M00000X
Nursing Facility/Intermediate Care Facility
Primary
0004362
OK
314000000X
Skilled Nursing Facility
375471
OK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100771500A
OK
Enumeration date
09/26/2006
Last updated
07/15/2008
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