Organization
COUNTRY LIVING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. JAMES CHARLES MONTLER (VP)
(740) 858-6327
Entity
Organization
Contact information
Practice address
13028 US HIGHWAY 52, WEST PORTSMOUTH, OH 45663-8909
(740) 858-6327
(740) 876-4831
Mailing address
PO BOX 175, FRIENDSHIP, OH 45630-0175
(740) 464-8973
(740) 876-4831
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Enumeration date
10/22/2020
Last updated
10/22/2020
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