Organization
COUNTRYSIDE MANOR LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KAREN HARROWER ADMINSTRATOR (ADMINSTRATOR)
(573) 473-2563
Entity
Organization
Contact information
Practice address
1415 E US HIGHWAY 54, VANDALIA, MO 63382-2908
(573) 594-6215
Mailing address
1415 E US HIGHWAY 54, VANDALIA, MO 63382-2908
(573) 594-6215
Taxonomy
Speciality
Code
Description
License number
State
251J00000X
Nursing Care Agency
Primary
—
—
Other
Enumeration date
10/09/2019
Last updated
10/09/2019
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