Organization
COUNTRY PINES INC
Active
Other names
Country Pines #1
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
2307 N BESTON RD, LA GRANGE, NC 28551-8627
(919) 778-4009
(919) 778-4009
Mailing address
2307 N BESTON RD, LA GRANGE, NC 28551-8627
(919) 778-4009
(919) 778-4009
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
MHL096117
NC
320800000X
Mental Illness Community Based Residential Treatment Facility
MHL096117
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3409221
CAP
NC
05
—
7804027
—
NC
01
—
8301207
COMM SUPPORT
NC
Enumeration date
05/07/2007
Last updated
09/04/2007
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