| NPI | 1093706830 |
|---|---|
| Doing Business As | COLONIAL MANOR |
| Entity Type | Organization |
| Authorized Contact | DAVID M UNDERWOOD Senior V.P. & CFO 309-823-7135 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 314000000X Skilled Nursing Facility (Licence: IL 0042168) |
| Additional Taxonomies | 225XP0019X Occupational Therapist, Physical Rehabilitation |
| 224Z00000X Occupational Therapy Assistant | |
| 2251G0304X Physical Therapist, Geriatrics | |
| 225200000X Physical Therapy Assistant | |
| 235Z00000X Speech-Language Pathologist, | |
| Enumeration Date | 2005-11-01 |
| Last Update Date | 2016-01-29 |