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NPI Code Detail

MEDICARE: COLONIAL HEALTH & REHAB CENTER, LLC

MEDICARE: COLONIAL HEALTH & REHAB CENTER, LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1314000000XSkilled Nursing Facility

General Provider Information

NPI Number : 1720697840
Entity Type Code : Organization
Provider Name (Legal Business Name) : COLONIAL HEALTH & REHAB CENTER, LLC
Provider Business Mailing Address
First Line : 23700 COMMERCE PARK
Second Line :
City : BEACHWOOD
State : OH
Zip : 44122-5827
Country : US
Telephone Number : 216-292-5706
Fax Number :
Provider Business Practice Location Address
First Line : 1604 OLD DONATION PKWY
Second Line :
City : VIRGINIA BEACH
State : VA
Zip : 23454-3063
Country : US
Telephone Number : 757-496-7100
Fax Number :
Authorized Official
Title or Position : PRESIDENT
Name : WILLIAM I. WEISBERG
Credential :
Telephone Number : 216-292-5706
Provider Enumeration Date : 07/24/2020
Last Update Date : 01/10/2022

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