COUNTRY PINES INC (NPI# 1467672535) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1467672535 |
| Entity Type | Organization |
| Organization Name | COUNTRY PINES INC |
| Other Organization Name | COUNTRY PINES GC |
| Practice Address |
2308 Oakdale Rd La Grange NC 28551-8627 |
| Mailing Address |
2307 N Beston Rd Lagrange NC 28551-8627 |
| Practice Telephone | 2527474868 |
| Mailing Telephone | 9197784009 |
| Mailing Fax Number | 9197784009 |
| Enumeration Date | 2007-04-30 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MR. KENNETH MICHAEL SAULS SR. (VICE PRESIDENT) |
| Authorized Official Telephone | 9197784009 |
| Authorized Official Credential | BS BUSINESS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 320800000X | Community Based Residential Treatment Facility, Mental Illness | MHL040014 | NC | Residential Treatment Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | 7804005 | 05 |
| Other Name | Type Code |
|---|---|
| Country Pines GC | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588873764 | Country Pines Inc | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 2600 N Beston Rd, Lagrange, NC 28551-8627 | 2007-05-22 |
| 1497968762 | Country Pines Inc | Community Based Residential Treatment Facility, Mental Illness | 2307 N Beston Rd, La Grange, NC 28551-8627 | 2007-05-07 |
| Street Address |
2308 OAKDALE RD |
| City | LA GRANGE |
| State | NC |
| Zip Code | 28551-8627 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992229215 | Christopher Webster | Physical Therapist | 3870 Falling Creek Road, Legrange, NC 28551 | 2017-07-28 |
| 1437527082 | Tanger Lee Jones | Counselor | 197 Brook Meadow Lane, Lagrange, NC 28551 | 2015-09-11 |
| 1235362161 | Daniel's Choices Youth Development, Inc. | Community/Behavioral Health | 525 Arba Jason Rd., La Grange, NC 28551 | 2009-08-26 |
| 1518942135 | Marjorie R Rachide | Nurse Practitioner | 101 South Carey Street, Lagrange, NC 28551 | 2005-12-07 |
| 1669611471 | Nova Ic, Inc. | Intermediate Care Facility, Mentally Retarded | 407 W. Washington Street, Lagrange, NC 28551-1623 | 2009-02-18 |
| 1447499330 | Nova Ic, Inc. | Intermediate Care Facility, Mentally Retarded | 405 W Washington St, La Grange, NC 28551-1623 | 2009-02-17 |
| 1629259676 | Advantage Care of North Carolina, LLC | Case Management | 111 S Caswell St, La Grange, NC 28551-1707 | 2007-11-19 |
| 1629118013 | Waters' Provider Care Services, Inc. | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 104 W James St, La Grange, NC 28551-1727 | 2007-02-07 |
| 1568586808 | Ant Mary's Family Care | Custodial Care Facility | 127 E Railroad St, La Grange, NC 28551-1741 | 2007-03-19 |
| 1720063340 | Carl L Haynes Jr. | Family Medicine | 101 S Carey St, La Grange, NC 28551-1805 | 2005-12-07 |
| Find all providers in zip 28551 | ||||
| Taxonomy Code | 320800000X |
| Grouping | Residential Treatment Facilities |
| Classification | Community Based Residential Treatment Facility, Mental Illness |
| A home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497968762 | Country Pines Inc | Community Based Residential Treatment Facility, Mental Illness | 2307 N Beston Rd, La Grange, NC 28551-8627 | 2007-05-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366041667 | Jalisa Jackson | Community Based Residential Treatment Facility, Mental Illness | 11413 Mangla Dr, Charlotte, NC 28214-8885 | 2020-10-19 |
| 1245837061 | Bliss Haven Group LLC | Community Based Residential Treatment Facility, Mental Illness | 2442 Sandhurst Ct, Gastonia, NC 28054-2738 | 2020-10-05 |
| 1386259265 | Nevaehs Caring Hands | Community Based Residential Treatment Facility, Mental Illness | 2509 Dalton Rd, Rocky Mount, NC 27803-4721 | 2020-09-09 |
| 1588279442 | C & C Homecare, LLC | Community Based Residential Treatment Facility, Mental Illness | 5119 Holdens Cross Rd, Wilson, NC 27893-8253 | 2020-09-08 |
| 1801409859 | Destiny & Miracle LLC | Community Based Residential Treatment Facility, Mental Illness | 1024 Houston St, Gastonia, NC 28052-1632 | 2020-08-28 |
| 1699329433 | Fresh Start Today Inc | Community Based Residential Treatment Facility, Mental Illness | 3707 Roseheim Ct, Greensboro, NC 27405-4867 | 2019-07-30 |
| 1003460833 | Care-in-full | Community Based Residential Treatment Facility, Mental Illness | 1338 Sharp Ridge Rd, Greensboro, NC 27406-8597 | 2019-07-30 |
| 1366001976 | Foundation of Hope, Inc. | Community Based Residential Treatment Facility, Mental Illness | 119 Grice Road, Chadbourn, NC 28431-6709 | 2019-06-07 |
| 1558927590 | Tall Family Services, Inc. | Community Based Residential Treatment Facility, Mental Illness | 1915 Hasty Rd, Marshville, NC 28103-0029 | 2019-05-15 |
| 1174187868 | Stepping Stone Services Inc. | Community Based Residential Treatment Facility, Mental Illness | 2720 White Oak Ln, Kannapolis, NC 28083-7256 | 2019-04-28 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.