Organization
OCOEE COLBY HEALTHCARE CENTER LLC
Active
Other names
Colonial Center
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN SHEEHAN (MEMBER)
(423) 618-1488
Entity
Organization
Contact information
Practice address
702 W DOLF ST, COLBY, WI 54421-9604
(715) 223-2352
(859) 281-5150
Mailing address
3915 ADKISSON DR NW, CLEVELAND, TN 37312-2821
(423) 834-3188
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
3080
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
20191800
—
WI
Enumeration date
09/15/2005
Last updated
06/07/2022
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