Healthcare Provider Details

I. General information

NPI: 1760446777
Provider Name (Legal Business Name): INFINIA AT COLBY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/14/2006
Last Update Date: 07/31/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

105 E COLLEGE DR
COLBY KS
67701-3701
US

IV. Provider business mailing address

105 E COLLEGE DR
COLBY KS
67701-3701
US

V. Phone/Fax

Practice location:
  • Phone: 785-462-6721
  • Fax:
Mailing address:
  • Phone: 785-462-6721
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

Name: MR. JON ROBERTSON
Title or Position: OWNER
Credential:
Phone: 801-296-5106