# COUNTRY PINES INC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Other names:** Country Pines \#2
- **Organization subpart:** No

## Provider details

- **NPI number:** 1588873764
- **Authorized official:** MR. KENNETH MICHAEL SAULS SR. BS BUSINESS (VICE PRESIDENT)
- **Authorized official phone:** (919) 778-4009

## Contact information

- **Practice address:** 2600 N BESTON RD, LAGRANGE, NC 28551-8627
- **Practice address phone:** (919) 778-1244
- **Mailing address:** 2307 N BESTON RD, LAGRANGE, NC 28551-8627
- **Mailing address phone:** (919) 778-4009
- **Mailing address fax:** (919) 778-4009

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 320600000X | Intellectual and/or Developmental Disabilities Residential Treatment Facility | MHL096115 | NC | Yes |

## Other

- **Enumeration date:** 05/22/2007
- **Last updated:** 08/22/2020