Colonial Manor LLC

Primary specialty

Intellectual and/or Developmental Disabilities Residential Treatment FacilityTaxonomy code 320600000X

License

320600000X Issued in MO

Legal business name

COLONIAL MANOR LLC

Practice address

907 W Malone Ave
Sikeston, MO 63801-2425

Phone

(573) 471-5541

Fax

(573) 471-3063

NPI assigned

Dec 11, 2006

Last updated

Jun 16, 2008By 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

Linda F Atchley

Title

Operator

Phone

(573) 471-5541

Specialties & licenses 1

Addresses

Other identifiers 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

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

{
    "created_epoch": "1165795200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213574400000",
    "number": "1437219508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "907 W MALONE AVE",
            "city": "SIKESTON",
            "state": "MO",
            "postal_code": "638012425",
            "telephone_number": "573-471-5541",
            "fax_number": "573-471-3063"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "907 W MALONE AVE",
            "city": "SIKESTON",
            "state": "MO",
            "postal_code": "638012425",
            "telephone_number": "573-471-5541",
            "fax_number": "573-471-3063"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLONIAL MANOR LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-11",
        "last_updated": "2008-06-16",
        "status": "A",
        "authorized_official_last_name": "ATCHLEY",
        "authorized_official_first_name": "LINDA",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "OPERATOR",
        "authorized_official_telephone_number": "573-471-5541"
    },
    "taxonomies": [
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "MO",
            "license": "320600000X",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "266744804",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Melissa L Christian, APRN
• Holly Renee Cohen, MACCC-SLP
• Angelica Jayde Colarossi, OTR/L
• Kelley Leann Collier, MSN, FNP-C
• Collins Acres Care Center Inc (Sikeston Convalescent Center)
• Lisa E Colwick, FNP
• Compass Therapy Solutions
• Compassionate Care Home Services
• Continu-Care
• Continu-Care Home Maker Service Inc

• Intellectual and/or Developmental Disabilities Residential Treatment Facility in Sikeston, MO
• Providers in Sikeston, MO by specialty
• Intellectual and/or Developmental Disabilities Residential Treatment Facility in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.