Organization · Type 2 NPI

Countryside Home, LLC

Assisted Living Facility · Lebanon, MO

NPI number 1043520133 Active

Practice location

24499 Park Dr
Lebanon, MO 65536-5843

Call (417) 532-7418 Map

Fax (417) 532-9359

Specialties and licenses

TaxonomyCodeLicense
Assisted Living Facility Primary 310400000XNone listed

Assisted Living Facility: A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being.

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About NPI 1043520133

Countryside Home, LLC's National Provider Identifier is 1043520133, issued on Oct 7, 2010. The primary taxonomy on file is Assisted Living Facility (310400000X), and the practice location is in Lebanon, MO. The record was last updated on Oct 7, 2010.