Organization · Type 2 NPI

Country Living Guest Home, Inc.

Intellectual and/or Developmental Disabilities Residential Treatment Facility · Washington, NC

NPI number 1104182005 Active

Practice location

618 Plant St
Washington, NC 27889

Call (252) 975-3741 Map

Fax (252) 975-3044

Mailing address

217 East 9th Street
Washington, NC 27889

Specialties and licenses

Taxonomy	Code	License
Community/Behavioral Health Agency	251S00000X	None listed
Adult Care Home Facility	311ZA0620X	None listed
Intellectual and/or Developmental Disabilities Residential Treatment Facility Primary	320600000X	None listed
Non-emergency Medical Transport (VAN)	343900000X	None listed

Intellectual and/or Developmental Disabilities Residential Treatment Facility: A residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with developmental and intellectual disabilities and are not able to live independently.

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About NPI 1104182005

Country Living Guest Home, Inc.'s National Provider Identifier is 1104182005, issued on Apr 4, 2012. The primary taxonomy on file is Intellectual and/or Developmental Disabilities Residential Treatment Facility (320600000X), and the practice location is in Washington, NC. The record was last updated on Oct 12, 2023.