NPI 1124129556 · live from the CMS NPI Registry
Colonial Manor Nursing Center, INC.
Skilled Nursing Facility in Tulsa, OK. National Provider Identifier 1124129556, active.
NPI record
| NPI | 1124129556 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Skilled Nursing Facility 314000000X |
| Practice location | 1815 E Skelly Dr, Tulsa, OK 74105 |
| Practice phone | 918-743-7838 |
| Enumerated | September 26, 2006 |
| Last updated | September 11, 2025 |
| Authorized official | Ed Rucker, Administrator |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Nursing Facility/Intermediate Care Facility | 313M00000X | NH7208-7208 (OK) |
| Skilled Nursing Facility primary | 314000000X | 375465 (OK) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.