Country Living Guest Home #2
LBN: Country Living Guest Home, Inc.
Country Living Guest Home #2 is an health care organization with primary practice located at 3052 Market Street Extension , Washington NC 27889-8126. The organization recently has 4 registered licenses in different health care specialties including Agencies / Community/Behavioral Health, Nursing & Custodial Care Facilities / Adult Care Home, Residential Treatment Facilities / Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities, Transportation Services / Non-emergency Medical Transport (VAN). Residential Treatment Facilities / Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities is the primary health care specialty.
Country Living Guest Home, Inc. can be contacted via phone (252) 975-3741, or through Hardison, Kellie Michelle via phone (252) 975-3741.
Contact Information
Primary practice address
3052 Market Street Extension
Washington NC 27889-8126
Phone: (252) 975-3741
Fax: (252) 975-3044
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Agencies / Community/Behavioral Health | 251S00000X | ||
| Nursing & Custodial Care Facilities / Adult Care Home | 311ZA0620X | ||
| Residential Treatment Facilities / Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 320600000X | ||
| Transportation Services / Non-emergency Medical Transport (VAN) | 343900000X |
Profile Details
| NPI number | 1558428045 |
|---|---|
| LBN Legal business name | Country Living Guest Home, Inc. |
| DBA Doing business as | Country Living Guest Home #2 |
| Authorized official | Hardison, Kellie Michelle MSW, LCSW |
| Entity | Organization |
| Organization subpart 1 | Yes |
| Enumeration date | Jan 3rd, 2007 |
| Last updated | Jul 27th, 2023 - about last year |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1558428045 | NPPES |
| North Carolina | MEDICAID | 7804660 |
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