COUNTRY TIME INN LLC NPI 1538155643

NPI Information

COUNTRY TIME INN LLC is an adult care home custodial care facility in Kings Mountain, NC. The provider is a custodial care facility providing supportive and personal care services to disabled and/or elderly individuals who cannot function independently in most areas of activity and need assistance and monitoring to enable them to remain in a home like environment. COUNTRY TIME INN LLC NPI is 1538155643. The provider is registered as an organization entity type.

The provider's business location address is:

602 BREVARD ST
KINGS MOUNTAIN, NC
ZIP 28086-692
Phone: (704) 739-2760
Fax: (704) 739-6252

The provider's authorized official is Charles E Trefzger .
The authorized official title is Manager and has the following contact phone number (828) 322-5535.

The CLIA number assigned to this NPI record is 34D2019403 - assisted living facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 9/23/2005 and was last updated on 7/28/2021.

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:

Other Identifiers

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

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.