Countryside Manor, Inc

LBN: Countryside Manor, Inc
Countryside Manor, Inc is an health care organization with primary practice located at 7700 Us Highway 158 , Stokesdale NC 27357-9346. The organization recently has 3 registered licenses in different health care specialties including Nursing & Custodial Care Facilities / Assisted Living Facility, Nursing & Custodial Care Facilities / Nursing Facility/Intermediate Care Facility, Nursing & Custodial Care Facilities / Skilled Nursing Facility. Nursing & Custodial Care Facilities / Assisted Living Facility is the primary health care specialty. Countryside Manor, Inc can be contacted via phone (336) 643-6301, or through Stanleh, Miles E via phone (336) 643-6301.

Contact Information

Primary practice address
7700 Us Highway 158 Stokesdale NC 27357-9346
Phone: (336) 643-6301
Fax: (336) 643-9906
Website:
Map and Directions
Authorized official contact:
Name: Stanleh, Miles E
Phone: (336) 643-6301

Health care specialties

SpecialtyCodeLicense #State
Nursing & Custodial Care Facilities / Assisted Living Facility 310400000X NH0226 North Carolina
Nursing & Custodial Care Facilities / Nursing Facility/Intermediate Care Facility 313M00000X NH0226 North Carolina
Nursing & Custodial Care Facilities / Skilled Nursing Facility 314000000X NH0226 North Carolina

Profile Details

NPI number 1992790810
LBN Legal business name Countryside Manor, Inc
DBA Doing business as
Authorized official Stanleh, Miles E
Entity Organization
Organization subpart 1 No
Enumeration date Sep 16th, 2005
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.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1992790810 NPPES
North Carolina MEDICAID 3415390
North Carolina MEDICAID 3416145

Popular Providers