| NPI | 1114908308 |
|---|---|
| Doing Business As | COLONIAL MANOR GUEST HOUSE |
| Entity Type | Organization |
| Authorized Contact | TEDDY RAY PRICE Managing Member 318-628-4116 |
| Organization Subpart ? | No |
| Primary Taxonomy | 314000000X Skilled Nursing Facility (Licence: LA 233) |
| Enumeration Date | 2005-11-07 |
| Last Update Date | 2020-08-22 |