Organization
HARRIS LEGACY HOUSE, LLC
Active
Organization
HARRIS LEGACY HOUSE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHARON K JACKSON MSN ED (EXECUTIVE DIRECTOR)
(816) 305-1616
Entity
Organization
Contact information
Practice address
2746 CYPRESS AVE, KANSAS CITY, MO 64128-1303
(816) 305-1616
Mailing address
2746 CYPRESS AVE, KANSAS CITY, MO 64128-1303
(816) 305-1616
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
12/13/2016
Last updated
12/13/2016
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