Colonial Living Center, LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

779 Issued in LA

Legal business name

COLONIAL LIVING CENTER, LLC

Doing business as

Colonial Oaks Living Center

Practice address

4312 Ithaca St
Metairie, LA 70006-2913

Phone

(504) 887-6414

Fax

(504) 887-5812

NPI assigned

Jul 5, 2005

Last updated

Feb 16, 2012By 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. David Hargrave

Title

Administrator

Phone

(504) 887-6414

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Colonial Oaks Living Center Doing business as

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

{
    "created_epoch": "1120521600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1329350400000",
    "number": "1720085723",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4312 ITHACA ST",
            "city": "METAIRIE",
            "state": "LA",
            "postal_code": "700062913",
            "telephone_number": "504-887-6414",
            "fax_number": "504-887-5812"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4312 ITHACA ST",
            "city": "METAIRIE",
            "state": "LA",
            "postal_code": "700062913",
            "telephone_number": "504-887-6414",
            "fax_number": "504-887-5812"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLONIAL LIVING CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-05",
        "last_updated": "2012-02-16",
        "status": "A",
        "authorized_official_last_name": "HARGRAVE",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "504-887-6414",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "LA",
            "license": "779",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ENTERAL",
            "identifier": "4704660001",
            "state": "LA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1521400",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Colonial Oaks Living Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Vernita Collins
• Carli Marie Collis, MS, PLPC
• Joseph John Collura Jr., DDS
• Colon & Rectal Surgery Associates
• Gabrielle Marie Colon
• Colonial Oaks Care Center of Metairie (Colonial Oaks Living Center)
• Columbus Medical Services (The Columbus Organization)
• Columbus Medical Services (The Columbus Organization)
• Columbus Medical Services (The Columbus Organization)
• Neal Comarda, MD

• Skilled Nursing Facility in Metairie, LA
• Providers in Metairie, LA by specialty
• Skilled Nursing Facility in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2012; 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.