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Organization

COUNTRY LIVING RETIREMENT HOME

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. RUTH J. GRIFFIN (OWNER/ADMINISTRATOR)
(919) 552-7501
Entity
Organization

Contact information

Practice address
181 OLD MILL ROAD, FUQUAY-VARINA, NC 27526-6177
(919) 552-7501
Mailing address
181 OLD MILL ROAD, FUQUAY-VARINA, NC 27526-6177
(919) 552-7501

Taxonomy

Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary

Other

Enumeration date
08/28/2007
Last updated
08/28/2007
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