Country Living Guest Home, Inc.

LBN: Country Living Guest Home, Inc.
Country Living Guest Home, Inc. is an health care organization with primary practice located at 3134 Market Street Ext , Washington NC 27889-8127. The organization recently has only one registered license in Residential Treatment Facilities / Psychiatric Residential Treatment Facility, which is considered as the primary health care specialty. Country Living Guest Home, Inc. can be contacted via phone (252) 975-3741, or through Hardison, Tim via phone (252) 402-7823.

Contact Information

Primary practice address
3134 Market Street Ext Washington NC 27889-8127
Phone: (252) 975-3741
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Hardison, Tim Registered Nurse (RN)
Phone: (252) 402-7823

Health care specialties

SpecialtyCodeLicense #State
Residential Treatment Facilities / Psychiatric Residential Treatment Facility 323P00000X MHL-007-043 North Carolina

Profile Details

NPI number 1902963499
LBN Legal business name Country Living Guest Home, Inc.
DBA Doing business as
Authorized official Hardison, Tim Registered Nurse (RN)
Entity Organization
Organization subpart 1 No
Enumeration date Jan 3rd, 2007
Last updated Aug 22nd, 2020 - about 4 years ago

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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1902963499 NPPES
North Carolina MEDICAID 7805415

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