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General NPI Number Information
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NPI Number | 1811168149
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Entity Type | Organization
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Legal Business Name | FARLEYS, INC.
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Dates
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Enumeration Date | 03/14/2008
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Last Update Date | 03/14/2008
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Provider Practice Location Address
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Address Line | 17562 IMPERIAL RD
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City | CARTHAGE
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State | MO
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Zip | 64836-8753
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Country | US
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Telephone | 417-358-6122
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Fax | 417-359-5267
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Provider Business Mailing Address
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Address Line | 17562 IMPERIAL RD
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City | CARTHAGE
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State | MO
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Zip | 64836-8753
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Country | US
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Telephone | 417-358-6122
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Fax | 417-359-5267
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Authorized Official
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Title or Position | OWNER
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Name | MR. PHILIP OMER FARLEY
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Credential |
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Telephone | 417-358-6122
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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 | 034923
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License Number State | MO
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