Colonial Manor Nursing & Rehabilitation Center, LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

920 Issued in LA

Legal business name

COLONIAL MANOR NURSING & REHABILITATION CENTER, LLC

Practice address

114 Whatley St
Rayville, LA 71269-3318

Phone

(318) 728-3251

Fax

(318) 728-6552

NPI assigned

Nov 9, 2006

Organization subpart

No

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

Authorized official

Name

Delbert T Wilbanks

Title

Managing Member

Phone

(318) 728-3251

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• COLONIAL MANOR NURSING & REHABILITATION CENTER Doing business as

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

{
    "created_epoch": "1163030400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1871663468",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "114 WHATLEY ST",
            "city": "RAYVILLE",
            "state": "LA",
            "postal_code": "712693318",
            "telephone_number": "318-728-3251",
            "fax_number": "318-728-6552"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "114 WHATLEY ST",
            "city": "RAYVILLE",
            "state": "LA",
            "postal_code": "712693318",
            "telephone_number": "318-728-3251",
            "fax_number": "318-728-6552"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLONIAL MANOR NURSING & REHABILITATION CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-09",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WILBANKS",
        "authorized_official_first_name": "DELBERT",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "318-728-3251"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "LA",
            "license": "920",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1517151",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "COLONIAL MANOR NURSING & REHABILITATION CENTER",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Christy Chapman
• Macee Cherry, CIT
• Wendi Butler Chevalier, FNP
• Jordan Paige Coker, CIT
• Colonial Manor Guest House, LLC
• Colonial Manor Nursing and Rehabilitation Home Inc
• Douglas Wayne Cook, M.D.
• Shelby Cook, LCSW
• Cookie'S Helping Hands
• Cookie'S Helping Hands, Inc.

• All providers in Rayville, LA
• Skilled Nursing Facility in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.