| NPI | 1285852798 |
|---|---|
| Doing Business As | COLONIAL VILLAGE |
| Entity Type | Organization |
| Authorized Contact | JON HARDER Medicaid Coordinator 903-758-6332 |
| Organization Subpart ? | No |
| Primary Taxonomy | 310400000X Assisted Living Facility |
| Enumeration Date | 2007-04-22 |
| Last Update Date | 2020-08-22 |