Provider Demographics
NPI:1811168149
Name:FARLEYS, INC.
Entity type:Organization
Organization Name:FARLEYS, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:PHILIP
Authorized Official - Middle Name:OMER
Authorized Official - Last Name:FARLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:417-358-6122
Mailing Address - Street 1:17562 IMPERIAL RD
Mailing Address - Street 2:
Mailing Address - City:CARTHAGE
Mailing Address - State:MO
Mailing Address - Zip Code:64836-8753
Mailing Address - Country:US
Mailing Address - Phone:417-358-6122
Mailing Address - Fax:417-359-5267
Practice Address - Street 1:17562 IMPERIAL RD
Practice Address - Street 2:
Practice Address - City:CARTHAGE
Practice Address - State:MO
Practice Address - Zip Code:64836-8753
Practice Address - Country:US
Practice Address - Phone:417-358-6122
Practice Address - Fax:417-359-5267
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-14
Last Update Date:2008-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO034923310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility