COUNTRY PINES INC NPI 1588873764

NPI Information

  • NPI: 1588873764
  • Provider Name: COUNTRY PINES INC
  • Classification: Residential Treatment Facility, Intellectual and/or Developmental Disabilities - 320600000X
  • Entity Type: Organization
  • Other Name: COUNTRY PINES #2
  • Address: 2600 N BESTON RD
    LAGRANGE, NC
    ZIP 28551
  • Phone: (919) 778-1244

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NPI Details

COUNTRY PINES INC is a residential treatment facility, intellectual and/or developmental disabilities in Lagrange, NC. The provider is a residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with developmental and intellectual disabilities and are not able to live independently. COUNTRY PINES INC NPI is 1588873764. The provider is registered as an organization entity type.
The provider Other Name Is Country Pines #2.

The provider's business location address is:

2600 N BESTON RD
LAGRANGE, NC
ZIP 28551-627
Phone: (919) 778-1244

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 5/22/2007 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
1320600000XResidential Treatment Facility, Intellectual and/or Developmental DisabilitiesMHL096115NORTH CAROLINAYes

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
17804004MEDICAIDNORTH 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: 11/21/2025

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