Organization
HARRIS REST HOME
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ILA GERTRUDE HARRIS (ADMINISTRATOR)
(919) 693-7591
Entity
Organization
Contact information
Practice address
1017 US HIGHWAY 158, ROUGEMONT, NC 27572-8368
(919) 693-7591
Mailing address
1017 US HIGHWAY 158, ROUGEMONT, NC 27572-8368
(919) 693-7591
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
FCL039002
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7802230
—
NC
Enumeration date
08/28/2007
Last updated
08/28/2007
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