- Enrollment id
- O20150609001516
- Enrollment state
- KS
- Provider type code
- 00-18
- Provider type text
- PART A PROVIDER - SKILLED NURSING FACILITY
- Npi
- 1285824797
- Multiple npi flag
- N
- Ccn
- 175202
- Associate id
- 5395066856
- Organization name
- COLBY OPERATOR LLC
- Doing business as name
- COLBY HEALTH AND REHAB
- Incorporation date
- 2015-02-25
- Incorporation state
- FL
- Organization type structure
- LLC
- Proprietary nonprofit
- P
- Nursing home provider name
- COLBY OPERATOR, LLC
- Affiliation entity name
- MISSION HEALTH COMMUNITIES
- Affiliation entity id
- 354
- Address line 1
- 105 E COLLEGE DR
- City
- COLBY
- State
- KS
- Zip code
- 677013701