MEDICARE: HARRIS HOUSE FOUNDATION

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	324500000X	Substance Abuse Rehabilitation Facility	3047-11270	MO

General Provider Information

NPI Number	:	1831436278
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HARRIS HOUSE FOUNDATION

Provider Business Mailing Address
First Line	:	2706 S RIVER RD
Second Line	:
City	:	SAINT CHARLES
State	:	MO
Zip	:	63303-5936
Country	:	US
Telephone Number	:	314-631-4299
Fax Number	:

Provider Business Practice Location Address
First Line	:	8315 S BROADWAY
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63111-3804
Country	:	US
Telephone Number	:	314-631-4299
Fax Number	:

Authorized Official
Title or Position	:	SENIOR MANAGER, HR
Name	:	JESSICA SAHAGUN
Credential	:
Telephone Number	:	314-631-4299

Provider Enumeration Date	:	01/04/2013
Last Update Date	:	02/06/2020

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Directions to “HARRIS HOUSE FOUNDATION ” Practice Location

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