Organization
COUNTRY LIVING CARE HOMES LLC
Active
Other names
Country Living Assisted Living
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOSEPH WALTER GOLDEN (OWNER/MANAGEMENT)
(417) 926-1955
Entity
Organization
Contact information
Practice address
2820 N MAIN AVE, MOUNTAIN GROVE, MO 65711-1403
(417) 926-1955
(417) 926-1951
Mailing address
PO BOX 649, MOUNTAIN GROVE, MO 65711-0649
(417) 926-1955
(417) 926-1951
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
039387
MO
Other
Enumeration date
07/23/2011
Last updated
08/29/2011
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