Organization
COUNTRY LIVING GUEST HOME, INC.
Active
Parent organization
COUNTRY LIVING GUEST HOME, INC.
Organization subpart
Yes
Provider details
NPI number
Legal business name
COUNTRY LIVING GUEST HOME, INC.
Authorized official
MISS KELLIE MICHELLE HARDISON MSW, LCSW (ADMINISTRATOR)
(252) 975-3741
Entity
Organization
Contact information
Practice address
207 W 11TH ST, WASHINGTON, NC 27889
(252) 975-3741
(252) 975-3044
Mailing address
217 EAST 9TH STREET, WASHINGTON, NC 27889
(252) 975-3741
(252) 975-3044
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
—
—
311ZA0620X
Adult Care Home Facility
—
—
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
—
—
343900000X
Non-emergency Medical Transport (VAN)
—
—
Other
Enumeration date
11/26/2012
Last updated
07/27/2023
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