Provider Demographics
NPI:1851418867
Name:MARY'S RANCH, INC.
Entity Type:Organization
Organization Name:MARY'S RANCH, INC.
Other - Org Name:MARBLE HILL ASSISTED LIVING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:MONICA
Authorized Official - Middle Name:LAYNE
Authorized Official - Last Name:JARRELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:573-238-4253
Mailing Address - Street 1:PO BOX 589
Mailing Address - Street 2:
Mailing Address - City:MARBLE HILL
Mailing Address - State:MO
Mailing Address - Zip Code:63764-0589
Mailing Address - Country:US
Mailing Address - Phone:573-238-4253
Mailing Address - Fax:573-238-4335
Practice Address - Street 1:RR 2 BOX 2790
Practice Address - Street 2:
Practice Address - City:MARBLE HILL
Practice Address - State:MO
Practice Address - Zip Code:63764-9510
Practice Address - Country:US
Practice Address - Phone:573-238-4253
Practice Address - Fax:573-238-4335
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility