Colonial Manor of Elma Inc

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

450794 Issued in IA

Legal business name

COLONIAL MANOR OF ELMA INC

Practice address

407 9TH St
Elma, IA 50628-8217

Phone

(641) 393-2134

Fax

(641) 393-2004

NPI assigned

Aug 12, 2005

Last updated

Jan 5, 2024By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Timothy Roberts

Title

Cfo

Phone

(641) 456-5636

Specialties & licenses 3

Addresses

Other identifiers 2

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1123804800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1704412800000",
    "number": "1285636910",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1320 4TH ST NE",
            "city": "HAMPTON",
            "state": "IA",
            "postal_code": "504411104",
            "telephone_number": "641-456-5636",
            "fax_number": "641-456-2320"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "407 9TH ST",
            "city": "ELMA",
            "state": "IA",
            "postal_code": "506288217",
            "telephone_number": "641-393-2134",
            "fax_number": "641-393-2004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLONIAL MANOR OF ELMA INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-12",
        "last_updated": "2024-01-05",
        "certification_date": "2024-01-05",
        "status": "A",
        "authorized_official_last_name": "ROBERTS",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "641-456-5636",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QA0600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Day Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "IA",
            "license": "450794",
            "primary": true
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLMARK",
            "identifier": "65386",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0800722",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Colonial Manor of Elma (Afton Oaks Independent Assisted Living)
• Colonial Manor of Elma
• Comprehensive Systems, Inc
• Alyssa Crawford, LCPC
• Elma Ia Skilled Nursing Facility, LLC
• Elma Ia Skilled Nursing Facility, LLC
• Elma Ia Skilled Nursing Facility, LLC

• Skilled Nursing Facility in Elma, IA
• Providers in Elma, IA by specialty
• Skilled Nursing Facility in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.