Healthcare Provider Details

I. General information

NPI: 1174519672
Provider Name (Legal Business Name): COLONIAL MANOR OF COLUMBUS COMMUNITY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/21/2005
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

814 SPRINGER AVE
COLUMBUS JUNCTION IA
52738-1305
US

IV. Provider business mailing address

814 SPRINGER AVE P.O. BOX 266
COLUMBUS JUNCTION IA
52738-1305
US

V. Phone/Fax

Practice location:
  • Phone: 319-728-2276
  • Fax: 319-728-8998
Mailing address:
  • Phone: 319-728-2276
  • Fax: 319-728-8998

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code313M00000X
TaxonomyNursing Facility/Intermediate Care Facility
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

Name: MR. RICHARD A KIRSCHLING
Title or Position: ADMINISTRATOR
Credential: CEO/ADMINISTRATOR
Phone: 319-728-2276