COUNTRY LIVING GUEST HOME #2 (NPI# 1558428045) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1558428045 |
| Entity Type | Organization |
| Organization Name | COUNTRY LIVING GUEST HOME #2 |
| Practice Address |
3052 Market Street Extension Washington NC 27889-8126 |
| Mailing Address |
217 East 9th Street Washington NC 27889-8126 |
| Practice Telephone | 2529753741 |
| Practice Fax Number | 2529753044 |
| Mailing Telephone | 2529753741 |
| Mailing Fax Number | 2529753044 |
| Enumeration Date | 2007-01-03 |
| Last Update Date | 2020-06-03 |
| Authorized Official Name | ANGELA CARROW HARDISON (OWNER) |
| Authorized Official Telephone | 2529753741 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 251S00000X | Community/Behavioral Health | Agencies | ||
| N | 311ZA0620X |
Custodial Care Facility Specialization: Adult Care Home |
Nursing & Custodial Care Facilities | ||
| N | 343900000X | Non-emergency Medical Transport (VAN) | Transportation Services | ||
| Y | 320600000X | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | Residential Treatment Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | 7804660 | 05 |
| Street Address |
3052 MARKET STREET EXTENSION |
| City | WASHINGTON |
| State | NC |
| Zip Code | 27889-8126 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336786326 | Coastal Solutions LLC | Counselor | 51 Hwy 33 W, Chocowinity, NC 27889 | 2019-12-09 |
| 1952946246 | Emily Hodges Hall | Pharmacy | 627 E 12th Street, Washington, NC 27889 | 2019-11-11 |
| 1649780032 | John Bailey Bland II | Chiropractor | 610 W. 15th. St., Washington, NC 27889 | 2017-10-11 |
| 1255780136 | County of Beaufort | Ambulance | 1420 Highland Drive, Washington, NC 27889 | 2016-06-10 |
| 1790175917 | Inner Coastal Orthotics and Prosthetics | Orthotist | 1102 North Brown St., Washington, NC 27889 | 2015-01-26 |
| 1972847390 | Country Living Guest Home #7 | Community/Behavioral Health | 207 W 11th St, Washington, NC 27889 | 2012-11-26 |
| 1104182005 | Country Living Guest Home #8 | Community/Behavioral Health | 618 Plant St, Washington, NC 27889 | 2012-04-04 |
| 1881986537 | Mary Lewis Scarbraugh | Social Worker | 408 E. 11th St., Washington, NC 27889 | 2011-05-12 |
| 1952615825 | Country Living Guest Home #6 | Community/Behavioral Health | 252 Dan Taylor Rd, Washington, NC 27889 | 2010-08-03 |
| 1376784371 | Jennifer Michele Richardson | Nurse Practitioner | 1207 Highland Drive, Washington, NC 27889 | 2009-03-20 |
| Find all providers in zip 27889 | ||||
| Taxonomy Code | 320600000X |
| Grouping | Residential Treatment Facilities |
| Classification | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities |
| A residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with developmental disabilities and/or mental retardation and are not able to live independently. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790395275 | The Verlyn Group Dc | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1341 H St Ne Ste 201, Washington, DC 20002-4406 | 2020-08-09 |
| 1689113722 | Surpassing The Average Rehabilitation Services (stars) | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 914 47th St Ne, Washington, DC 20019-3722 | 2017-02-22 |
| 1598152787 | Valentine Community Services, LLC. | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 617 Raleigh Pl Se, Washington, DC 20032-4221 | 2015-04-25 |
| 1003205261 | Bridge To Independent Living, LLC. | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 5004 2nd St Nw Apt 1, Washington, DC 20011-4170 | 2015-01-12 |
| 1083035125 | Capitol Hill Supportive Services Program Inc. | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 2052 W Virginia Ave Ne, Washington, DC 20002-1832 | 2013-12-16 |
| 1558605733 | Mind & Reason Advocacy Group, LLC. | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 2806 Pomeroy Rd Se, 2808 Pomeroy Rd Se, Washington, DC 20020-5912 | 2012-11-12 |
| 1457610586 | Vcare, LLC | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 8112 Eastern Ave Nw, Washington, DC 20012-1312 | 2012-05-09 |
| 1174896260 | Prudent Health Care Services Inc. | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1014 9th St Ne, Washington, DC 20002-3716 | 2012-02-20 |
| 1609157973 | Dc Health Care Services, Inc | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 2833 Georgia Ave Nw, Washington, DC 20001-3862 | 2011-08-31 |
| 1215239389 | Dc Residential Services Inc | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 4356 Varnum Pl Ne, Washington, DC 20017-2101 | 2010-11-23 |
| Find all providers in WASHINGTON | ||||
| City | WASHINGTON |
| Zip Code | 27889 |
Please comment or provide details below to improve the information on COUNTRY LIVING GUEST HOME #2.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.