Provider Demographics
NPI:1689863326
Name:COLONIAL COURTYARD IN-HOME SENIOR CARE
Entity Type:Organization
Organization Name:COLONIAL COURTYARD IN-HOME SENIOR CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGEMENT
Authorized Official - Prefix:
Authorized Official - First Name:JEAN
Authorized Official - Middle Name:
Authorized Official - Last Name:KLINGER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:814-329-2353
Mailing Address - Street 1:1300 LEONARD ST
Mailing Address - Street 2:
Mailing Address - City:CLEARFIELD
Mailing Address - State:PA
Mailing Address - Zip Code:16830-3255
Mailing Address - Country:US
Mailing Address - Phone:814-765-0300
Mailing Address - Fax:814-765-0314
Practice Address - Street 1:1300 LEONARD ST
Practice Address - Street 2:
Practice Address - City:CLEARFIELD
Practice Address - State:PA
Practice Address - Zip Code:16830-3255
Practice Address - Country:US
Practice Address - Phone:814-765-0300
Practice Address - Fax:814-765-0314
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-18
Last Update Date:2007-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health