Organization
COUNTRY PINES INC
Active
Other names
Country Pines GC
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KENNETH MICHAEL SAULS SR. BS BUSINESS (VICE PRESIDENT)
(919) 778-4009
Entity
Organization
Contact information
Practice address
2308 OAKDALE RD, LA GRANGE, NC 28551-8627
(252) 747-4868
Mailing address
2307 N BESTON RD, LAGRANGE, NC 28551-8627
(919) 778-4009
(919) 778-4009
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
MHL040014
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7804005
—
NC
Enumeration date
04/30/2007
Last updated
08/22/2020
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us