| Organization Name: | COLONIAL MANORS OF FAYETTE, INC |
| NPI Number: | 1801889811 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | DEBRA J HELDT (NURSING HOME ADMINISTRATOR) |
| Mailing Address: | 100 Bolger Dr Fayette |
| State: | IA US |
| Postal Code: | 521429762 |
| Phone Number: | 5634253336 |
| Fax Number: | 5634253512 |
| NPI Enumeration Date: | 08/24/2005 |
| NPI Last Update Date: | 09/14/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 310400000X |
| License Number: | S0204 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | IA |
| Taxonomy Type: | Nursing & Custodial Care Facilities |
| Taxonomy Classification: | Assisted Living Facility |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being. |