Organization
COUNTRYSIDE THERAPY GROUP, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LAURA MONTGOMERY OTR (ADMINISTRATOR/CEO)
(254) 965-3611
Entity
Organization
Contact information
Practice address
515 W LINGLEVILLE RD, STEPHENVILLE, TX 76401-2211
(254) 965-3611
(254) 965-3618
Mailing address
515 W LINGLEVILLE RD, STEPHENVILLE, TX 76401-2211
(254) 965-3611
(254) 965-3618
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
—
—
225100000X
Physical Therapist
—
—
225200000X
Physical Therapy Assistant
—
—
225X00000X
Occupational Therapist
—
—
235Z00000X
Speech-Language Pathologist
—
—
251E00000X
Home Health Agency
009330
TX
261QR0400X
Rehabilitation Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
172242301
—
TX
Enumeration date
08/13/2006
Last updated
01/05/2026
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