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General NPI Number Information
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NPI Number | 1295281517
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Entity Type | Organization
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Legal Business Name | HARBOR PLACE ESTATES, LLC
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Dates
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Enumeration Date | 08/28/2016
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Last Update Date | 08/28/2016
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Provider Practice Location Address
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Address Line | 1054 S STATE HIGHWAY 47
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City | WARRENTON
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State | MO
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Zip | 63383
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Country | US
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Telephone | 314-377-4444
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Fax | 314-377-4446
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Provider Business Mailing Address
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Address Line | 1054 S STATE HIGHWAY
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City | WARRENTON
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State | MO
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Zip | 63383
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Country | US
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Telephone | 314-377-4444
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Fax | 314-377-4446
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Authorized Official
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Title or Position | OWNER
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Name | MRS. JENNIFER GETTMAN
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Credential |
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Telephone | 636-219-3114
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number | 044167
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License Number State | MO
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