Country Living Guest Home, Inc

NPI 1104182005 - Psychiatric Residential Treatment Facility - 323P00000X

NPI Details
NPI 1104182005
Enumeration Date 04/04/2012
Last Updated 04/04/2012
Entity Type Healthcare Provider
Active Over 4 years ago
Authorized Information
Name TIMOTHY TIMOTHY
Position OWNER/ADMINISTRATOR
Phone (252) 940-0230
Fax
Practice Location
618 PLANT ST
WASHINGTON NC, 27889-4117, US
Phone (252) 940-0230
Fax
Business Location
3134 MARKET STREET EXT
WASHINGTON NC, 27889-8127, US
Phone (252) 975-3741
Fax
Toxanomy
Taxonomy Code 323P00000X
License State North Carolina
License Number MHL007079
Remove 1104182005 NPI Number
 

According to our database, Country Living Guest Home, Inc NPI is 1104182005, taxonomy code is 323P00000X and license number is MHL007079, license state is located at North Carolina. Country Living Guest Home, Inc physically located at 618 Plant St, Washington NC, 27889-4117. NPI Number 1033115704 has the healthcare provider type.

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1104182005 NPI number is provided on an as is basis without warranty of any kind. 1104182005 is maintained by the National Plan & Provider Enumeration System. The contents of Country Living Guest Home, Inc are for informational purposes only.