<Unavail>
LBN: Colonial Manor Ltc, Llc
<Unavail> is an health care organization with primary practice located at 1528 Market Ave N , Canton OH 44714-2695. The organization recently has 2 registered licenses in different health care specialties including Nursing & Custodial Care Facilities / Nursing Facility/Intermediate Care Facility, Nursing & Custodial Care Facilities / Skilled Nursing Facility. Nursing & Custodial Care Facilities / Skilled Nursing Facility is the primary health care specialty.
Colonial Manor Ltc, Llc can be contacted via phone (330) 453-8466, or through Slyk, Michael P via phone (330) 424-3721.
Contact Information
Primary practice address
1528 Market Ave N
Canton OH 44714-2695
Phone: (330) 453-8466
Fax: (330) 453-1424
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Nursing & Custodial Care Facilities / Nursing Facility/Intermediate Care Facility | 313M00000X | 3620 | Ohio |
| Nursing & Custodial Care Facilities / Skilled Nursing Facility | 314000000X | 3620 | Ohio |
Profile Details
| NPI number | 1164411187 |
|---|---|
| LBN Legal business name | Colonial Manor Ltc, Llc |
| DBA Doing business as | <Unavail> |
| Authorized official | Slyk, Michael P PHARMD FASCP |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Oct 21st, 2005 |
| Last updated | Sep 11th, 2025 - about last year |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1164411187 | NPPES |
| Ohio | MEDICAID | 0177544 | |
| Ohio | MEDICAID | 2635938 |
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