COUNTRY PLACE VILLAGE I LP NPI 1891817094

NPI Information

NPI: 1891817094
Provider Name: COUNTRY PLACE VILLAGE I LP
Classification: Assisted Living Facility - 310400000X
Entity Type: Organization
Address:
2103 CHANDLER ST
KILGORE, TX
ZIP 75662
Phone: (903) 984-7827
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COUNTRY PLACE VILLAGE I LP is an assisted living facility in Kilgore, TX. 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. COUNTRY PLACE VILLAGE I LP NPI is 1891817094. The provider is registered as an organization entity type.

The provider's business location address is:

2103 CHANDLER ST
KILGORE, TX
ZIP 75662-741
Phone: (903) 984-7827

The provider's authorized official is Brian K Clarke .
The authorized official title is President Ceo and has the following contact phone number (903) 566-8500.

The enumeration date for this NPI number is 4/6/2007 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	310400000X	Assisted Living Facility		100561	TEXAS	Yes

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

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