COUNTRY PINES INC NPI 1467672535

NPI Information

NPI: 1467672535
Provider Name: COUNTRY PINES INC

Other Name: COUNTRY PINES GC

Classification: Community Based Residential Treatment Facility, Mental Illness - 320800000X
Entity Type: Organization
Address:
2308 OAKDALE RD
LA GRANGE, NC
ZIP 28551
Phone: (252) 747-4868
Get Directions

COUNTRY PINES INC is a community based residential treatment facility mental illness in La Grange, NC. The provider is a home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness. COUNTRY PINES INC NPI is 1467672535. The provider is registered as an organization entity type.
The provider Other Name Is Country Pines Gc.

The provider's business location address is:

2308 OAKDALE RD
LA GRANGE, NC
ZIP 28551-627
Phone: (252) 747-4868

The provider's authorized official is Kenneth Michael Sauls .
The authorized official title is Vice President and has the following contact phone number (919) 778-4009.

The enumeration date for this NPI number is 4/30/2007 and was last updated on 8/22/2020.

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:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	320800000X	Community Based Residential Treatment Facility, Mental Illness		MHL040014	NORTH CAROLINA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	7804005	MEDICAID	NORTH CAROLINA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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.

« Previous NPI

Next NPI »