# HARRIS REST HOME

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1508050188
- **Authorized official:** MRS. ILA GERTRUDE HARRIS (ADMINISTRATOR)
- **Authorized official phone:** (919) 693-7591

## Contact information

- **Practice address:** 1017 US HIGHWAY 158, ROUGEMONT, NC 27572-8368
- **Practice address phone:** (919) 693-7591
- **Mailing address:** 1017 US HIGHWAY 158, ROUGEMONT, NC 27572-8368
- **Mailing address phone:** (919) 693-7591

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 311ZA0620X | Adult Care Home Facility | FCL039002 | NC | Yes |

## Other

- **Enumeration date:** 08/28/2007
- **Last updated:** 08/28/2007

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 7802230 | — | NC |