Colonial Manor, INC

NPI #1619291820 in Zeigler, Illinois

Provider Information

NPI Number: 1619291820
Entity Type: Organization
Organization Name: Colonial Manor, INC
Primary Specialty: Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Enumeration Date: Mar 16, 2010
Last Updated: Mar 16, 2010

Practice Location

Address: 300 CHURCH ST
City: Zeigler
State: Illinois
ZIP Code: 62999-1043
Phone: (618) 596-6635

Authorized Official

Name: MELISSA K MOORE
Title: PRESIDENT
Phone: (618) 596-6635

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Residential Treatment Facility, Intellectual and/or Developmental Disabilities	320600000X	Primary

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