OrganizationActive
Colonial Manor LLC
NPI 1437219508 · Intellectual and/or Developmental Disabilities Residential Treatment Facility · Sikeston, MO
Provider details
- NPI number
- 1437219508
- Entity type
- Organization
- Primary specialty
- Intellectual and/or Developmental Disabilities Residential Treatment FacilityResidential Treatment Facilities
- Organization subpart
- No
- Authorized official
- Linda Atchley, Operator(573) 471-5541
- License
- 320600000X (MO)
Specialties & taxonomies
- Intellectual and/or Developmental Disabilities Residential Treatment FacilityPrimary320600000XLicense 320600000X (MO)
Residential Treatment Facilities
Practice location
907 W Malone Ave
Sikeston, MO 63801-2425
Phone: (573) 471-5541
Fax: (573) 471-3063
Approximate (ZIP-level) locationGet directions
Mailing address
907 W Malone Ave
Sikeston, MO 63801-2425
Registry dates
- Enumerated
- 2006-12-11
- Last updated
- 2008-06-16
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.