Organization · Type 2 NPI

Country Living Guest Home, Inc.

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

NPI number 1912064064 Active

Practice location

3094 Market Street Extension
Washington, NC 27889-8126

Call (252) 975-3741 Map

Fax (252) 975-3044

Mailing address

217 East 9th Street
Washington, NC 27889-8126

Specialties and licenses

TaxonomyCodeLicense
Community/Behavioral Health Agency 251S00000XNone listed
Adult Care Home Facility 311ZA0620XNone listed
Intellectual and/or Developmental Disabilities Residential Treatment Facility Primary 320600000XNone listed
Non-emergency Medical Transport (VAN) 343900000XNone 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 1912064064

Country Living Guest Home, Inc.'s National Provider Identifier is 1912064064, issued on Jan 1, 2007. 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 Jun 3, 2020.