COUNTRYSIDE HAVEN ASSISTED LIVING NPI 1396281887

NPI Information

COUNTRYSIDE HAVEN ASSISTED LIVING is an assisted living facility in Palm Harbor, FL. The provider is a facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being. COUNTRYSIDE HAVEN ASSISTED LIVING NPI is 1396281887. The provider is registered as an organization entity type.

The provider's business location address is:

6960 COUNTY ROAD 95
PALM HARBOR, FL
ZIP 34684-403
Phone: (727) 786-8461
Fax: (727) 784-0425

The provider's authorized official is Kathy Coogan .
The authorized official title is Owner and has the following contact phone number (727) 534-6766.

The CLIA number assigned to this NPI record is 10D2210842 - assisted living facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 1/9/2017 and was last updated on 1/9/2017.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.