Colonial Manor I LLC
NPI #1013720283 in Shelbyville, Kentucky
Provider Information
- NPI Number
- 1013720283
- Entity Type
- Organization
- Organization Name
- Colonial Manor I LLC
- Primary Specialty
- Assisted Living Facility - Assisted Living, Mental Illness
- Enumeration Date
- Jan 30, 2025
- Last Updated
- Jan 30, 2025
Practice Location
- Address
- 920 HENRY CLAY ST
- City
- Shelbyville
- State
- Kentucky
- ZIP Code
- 40065-1333
- Phone
- (516) 708-3503
Authorized Official
- Name
- RAQUEL EDERY
- Title
- COO
- Phone
- (516) 708-3503
Specialties & Taxonomy Codes
| Specialty |
|---|
| Assisted Living Facility - Assisted Living, Mental Illness — Assisted Living, Mental Illness |
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