| NPI | 1548504954 |
|---|---|
| Doing Business As | COLONIAL MANOR |
| Entity Type | Organization |
| Authorized Contact | DAVID M UNDERWOOD Exec VP, CFO 309-823-7135 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 314000000X Skilled Nursing Facility (Licence: IL 0053413) |
| Additional Taxonomies | 332BX2000X Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies |
| Enumeration Date | 2012-11-26 |
| Last Update Date | 2016-01-29 |