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Organization

COMMUNITY MANOR, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. SHARO SHIRSHEKAN (CEO/MANAGING MEMBER)
(573) 701-0600
Entity
Organization

Contact information

Practice address
783 WEBER RD, FARMINGTON, MO 63640
(573) 756-8998
(573) 756-8980
Mailing address
765 WEBER RD, FARMINGTON, MO 63640
(573) 701-0600
(573) 701-0601

Taxonomy

Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
031313
MO

Other

Enumeration date
10/02/2006
Last updated
08/22/2020
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