Colonial Healthcare, Inc.

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

030000049 Issued in CA

Legal business name

COLONIAL HEALTHCARE, INC.

Practice address

12225 Shale Ridge LN
Auburn, CA 95602-8870

Phone

(530) 885-7511

Fax

(530) 885-1845

NPI assigned

Jul 19, 2005

Organization subpart

Yes

Parent organization

HORIZON WEST HEALTHCARE OF CALIFORNIA, INC.As reported in NPPES

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

Authorized official

Name

Larry E Bear

Title

Chief Executive Officer

Phone

(916) 624-6230

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Hilltop Manor Care Center, Inc. Former legal business name

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

{
    "created_epoch": "1121731200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213056000000",
    "number": "1679572986",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4020 SIERRA COLLEGE BLVD",
            "address_2": "SUITE #190",
            "city": "ROCKLIN",
            "state": "CA",
            "postal_code": "956773906",
            "telephone_number": "916-624-6230",
            "fax_number": "916-624-6249"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12225 SHALE RIDGE LN",
            "city": "AUBURN",
            "state": "CA",
            "postal_code": "956028870",
            "telephone_number": "530-885-7511",
            "fax_number": "530-885-1845"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLONIAL HEALTHCARE, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "HORIZON WEST HEALTHCARE OF CALIFORNIA, INC.",
        "enumeration_date": "2005-07-19",
        "last_updated": "2008-06-10",
        "status": "A",
        "authorized_official_last_name": "BEAR",
        "authorized_official_first_name": "LARRY",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "916-624-6230"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "CA",
            "license": "030000049",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZZR05776G",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Hilltop Manor Care Center, Inc.",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Jeannette Cohen
• Randall Scott Cohen, M.D.
• Catherine Mary Coleman
• Jaiydyn Collier
• Leslie Anne Collins
• Heather M Colquhoun
• Congregational Church Retirement Community
• Desiree Coniglio, NP
• Lauren Conklin
• Charlene Ruth Conley, LCSW

• Skilled Nursing Facility in Auburn, CA
• Providers in Auburn, CA by specialty
• Skilled Nursing Facility in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2008; 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.