COUNTRY LIVING GUEST HOME, INC. is a residential treatment facility, intellectual and/or developmental disabilities in Washington, 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 LIVING GUEST HOME, INC. NPI is 1912064064. The provider is registered as an organization entity type.
The provider's business location address is:
3094 MARKET STREET EXTENSION
WASHINGTON, NC
ZIP 27889-126
Phone: (252) 975-3741
Fax: (252) 975-3044
The provider's authorized official is Angela Carrow Hardison .
The authorized official title is Owner and has the following contact phone number (252) 975-3741.
The CLIA number assigned to this NPI record is 34D2086749 - other - supervised living 5600c with a certificate type of Certificate of Waiver.
The enumeration date for this NPI number is 1/1/2007 and was last updated on 6/3/2020.