# PREMIER OPERATING COUNTRYSIDE VILLAGE, LLC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** PREMIER SENIOR LIVING, LLC
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1467808329
- **Legal business name:** PREMIER SENIOR LIVING, LLC
- **Authorized official:** ROBERT BORSODY (PRINCIPAL)
- **Authorized official phone:** (212) 739-0794

## Contact information

- **Practice address:** 5383 US HIGHWAY 117 N, PIKEVILLE, NC 27863-9443
- **Practice address phone:** (919) 242-6369
- **Practice address fax:** (919) 242-9884
- **Mailing address:** 5383 US HIGHWAY 117 N, PIKEVILLE, NC 27863-9443
- **Mailing address phone:** (919) 242-6369
- **Mailing address fax:** (919) 242-9884

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 311ZA0620X | Adult Care Home Facility | — | NC | Yes |

## Other

- **Enumeration date:** 05/10/2016
- **Last updated:** 05/10/2016