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General NPI Number Information
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NPI Number | 1285824797
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Entity Type | Organization
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Legal Business Name | COLBY OPERATOR, LLC
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Dates
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Enumeration Date | 07/31/2007
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Last Update Date | 09/03/2015
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Provider Practice Location Address
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Address Line | 105 E. COLLEGE DR.
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City | COLBY
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State | KS
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Zip | 67701-3701
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Country | US
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Telephone | 785-462-6721
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Fax | 785-460-2136
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Provider Business Mailing Address
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Address Line | 105 E. COLLEGE DR.
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City | COLBY
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State | KS
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Zip | 67701-3701
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Country | US
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Telephone | 785-462-6721
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Fax | 785-460-2136
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Authorized Official
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Title or Position | CEO
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Name | MR. STUART LINDEMAN
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Credential |
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Telephone | 813-440-8345
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number | N097002
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License Number State | KS
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