Colonial Manor Guest House, LLC
Organization Active NPI Skilled Nursing Facility · Rayville, LA
NPI 1114908308 · NPPES record last updated Aug 22, 2020
Key facts
- NPI
- 1114908308
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Skilled Nursing Facility 314000000X
- License
- 233 (LA)
- Legal business name
- COLONIAL MANOR GUEST HOUSE, LLC
- Practice address
- 114 Whatley St
Rayville, LA 71269-3318 - Phone
- (318) 728-3252
- Fax
- (318) 728-6552
- NPI assigned
- Nov 7, 2005
- Organization subpart
- No
Authorized official
- Name
- Mr. Teddy Ray Price
- Title
- Managing Member
- Phone
- (318) 628-4116
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | 233 | LA | Yes |
Addresses
Primary practice location
114 Whatley St
Rayville, LA 71269-3318
Mailing address
PO Box 874
Rayville, LA 71269-0874
Phone (318) 728-3252
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1517151 | Medicaid | LA |
Other names
- Colonial Manor Guest House
Other providers in Rayville, LA
- Changing Lives Counseling and Mentoring, LLC
- Christy Chapman
- Macee Cherry
- Wendi Butler Chevalier
- Jordan Paige Coker
- Colonial Manor Nursing & Rehabilitation Center, LLC
- Colonial Manor Nursing and Rehabilitation Home Inc
- Douglas Wayne Cook
- Shelby Cook
- Cookie'S Helping Hands
All providers in Rayville, LA · Skilled Nursing Facility in Louisiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 22, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.