NPI 1902963499

Country Living Guest Home, INC.

Organisation Psychiatric Residential Treatment Facility Washington, NC

Practice location

Address: 3134 Market Street Ext, Washington, NC 27889-8127
Phone: (252) 975-3741

Authorised official

Name: Tim Hardison
Title: Administrator
Phone: (252) 402-7823

Registered specialties

Psychiatric Residential Treatment Facility Primary

Residential Treatment Facilities Taxonomy 323P00000X Licence MHL-007-043 (NC)

Other Psychiatric Residential Treatment Facility providers in North Carolina →

Registry record

NPI: 1902963499
Entity type: Organization
NPI issued: 3 Jan 2007
Record last updated: 22 Aug 2020

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.