Organization
COUNTRYSIDE MANOR
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KAREN KAYE HARROWER LPN (DIRECTOR OF NURSING)
(573) 594-6215
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
310400000X
Assisted Living Facility
Primary
0327
MO
Other
Enumeration date
06/06/2007
Last updated
08/22/2020
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