Provider Demographics
NPI:1043407158
Name:HARRIS CARE CENTERS, INC.
Entity Type:Organization
Organization Name:HARRIS CARE CENTERS, INC.
Other - Org Name:MARIAN CLIFF MANOR
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:ELANE
Authorized Official - Middle Name:
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:573-760-9376
Mailing Address - Street 1:PO BOX 675
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON
Mailing Address - State:MO
Mailing Address - Zip Code:63640-0675
Mailing Address - Country:US
Mailing Address - Phone:573-760-9376
Mailing Address - Fax:573-760-9386
Practice Address - Street 1:381 ELM ST
Practice Address - Street 2:
Practice Address - City:SAINT MARY
Practice Address - State:MO
Practice Address - Zip Code:63673-9330
Practice Address - Country:US
Practice Address - Phone:573-543-2218
Practice Address - Fax:573-543-2262
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HARRIS CARE CENTERS, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-10-02
Last Update Date:2007-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility