COUNTRY LIVING GUEST HOME, INC. (NPI# 1902963499) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1902963499 |
| Entity Type | Organization |
| Organization Name | COUNTRY LIVING GUEST HOME, INC. |
| Practice Address |
3134 Market Street Ext Washington NC 27889-8127 |
| Practice Telephone | 2529753741 |
| Mailing Telephone | 2529753741 |
| Enumeration Date | 2007-01-03 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MR. TIM HARDISON (ADMINISTRATOR) |
| Authorized Official Telephone | 2524027823 |
| Authorized Official Credential | R.N. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 323P00000X | Psychiatric Residential Treatment Facility | MHL-007-043 | NC | Residential Treatment Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | 7805415 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912064064 | Country Living Guest Home, Inc. | Community/Behavioral Health | 3094 Market Street Extension, Washington, NC 27889-8126 | 2007-01-01 |
| Street Address |
3134 MARKET STREET EXT |
| City | WASHINGTON |
| State | NC |
| Zip Code | 27889-8127 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093195554 | Kellie Michelle Hardison | Social Worker | 3134 Market Street Ext, Washington, NC 27889-8127 | 2015-05-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336786326 | Coastal Solutions LLC | Counselor | 51 Hwy 33 W, Chocowinity, NC 27889 | 2019-12-09 |
| 1952946246 | Emily Hodges Hall | Pharmacy | 627 E 12th Street, Washington, NC 27889 | 2019-11-11 |
| 1649780032 | John Bailey Bland II | Chiropractor | 610 W. 15th. St., Washington, NC 27889 | 2017-10-11 |
| 1255780136 | County of Beaufort | Ambulance | 1420 Highland Drive, Washington, NC 27889 | 2016-06-10 |
| 1790175917 | Inner Coastal Orthotics and Prosthetics | Orthotist | 1102 North Brown St., Washington, NC 27889 | 2015-01-26 |
| 1972847390 | Country Living Guest Home #7 | Community/Behavioral Health | 207 W 11th St, Washington, NC 27889 | 2012-11-26 |
| 1104182005 | Country Living Guest Home #8 | Community/Behavioral Health | 618 Plant St, Washington, NC 27889 | 2012-04-04 |
| 1881986537 | Mary Lewis Scarbraugh | Social Worker | 408 E. 11th St., Washington, NC 27889 | 2011-05-12 |
| 1952615825 | Country Living Guest Home #6 | Community/Behavioral Health | 252 Dan Taylor Rd, Washington, NC 27889 | 2010-08-03 |
| 1376784371 | Jennifer Michele Richardson | Nurse Practitioner | 1207 Highland Drive, Washington, NC 27889 | 2009-03-20 |
| Find all providers in zip 27889 | ||||
| Taxonomy Code | 323P00000X |
| Grouping | Residential Treatment Facilities |
| Classification | Psychiatric Residential Treatment Facility |
| A residential treatment facility (RTF) is a facility or distinct part of a facility that provides to children and adolescents, a total, twenty-four hour, therapeutically planned group living and learning situation where distinct and individualized psychotherapeutic interventions can take place. Residential treatment is a specific level of care to be differentiated from acute, intermediate, and long-term hospital care, when the least restrictive environment is maintained to allow for normalization of the patient’s surroundings. The RTF must be both physically and programmatically distinct if it is a part or subunit of a larger treatment program. An RTF is organized and professionally staffed to provide residential treatment of mental disorders to children and adolescents who have sufficient intellectual potential to respond to active treatment (that is, for whom it can reasonably be assumed that treatment of the mental disorder will result in an improved ability to function outside the RTF) for whom outpatient treatment, partial hospitalization or protected and structured environment is medically or psychologically necessary |
| Notes: Source: Champus Policy manual, Volume II, p. 6010.47M dated 9/12/94. Revision: Definition title revised 7/1/03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831301787 | Alternative Solutions for Youth, LLC | Psychiatric Residential Treatment Facility | 1301 L'enfant Square Se, Washington, DC 20020 | 2007-05-04 |
| 1023569522 | Wooded Acres Guest Home Inc. | Psychiatric Residential Treatment Facility | 3706 Cherry Rd, Washington, NC 27889-7268 | 2016-10-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740840990 | Alexander Youth Network | Psychiatric Residential Treatment Facility | 1601 Huffine Mill Rd., Bldg B, Greensboro, NC 27405-5509 | 2019-06-19 |
| 1578067146 | Alexander Youth Network | Psychiatric Residential Treatment Facility | 6220e Thermal Rd, Charlotte, NC 28211-5630 | 2018-03-20 |
| 1750827150 | Stephen's Home | Psychiatric Residential Treatment Facility | 6214 Paylor St, Mebane, NC 27302-7020 | 2017-01-10 |
| 1013450055 | Rwilliams | Psychiatric Residential Treatment Facility | 511 Tansy Dr, Charlotte, NC 28214-8832 | 2016-11-23 |
| 1891247490 | Healing Community Adult Cre | Psychiatric Residential Treatment Facility | 55 Congress St, Asheville, NC 28801-4342 | 2016-10-30 |
| 1598219149 | Equinox Rtc, LLC | Psychiatric Residential Treatment Facility | 2420 Middle Fork Rd, Hendersonville, NC 28792-1032 | 2016-08-12 |
| 1497128631 | The Woodard Home | Psychiatric Residential Treatment Facility | 4100 Cherry Tree Dr, Monroe, NC 28110-9692 | 2015-11-10 |
| 1184096661 | Canyon Hills Treatment Facility, LLC | Psychiatric Residential Treatment Facility | 769 Aberdeen Rd, Raeford, NC 28376-0029 | 2015-10-23 |
| 1891164174 | Kearney Home | Psychiatric Residential Treatment Facility | 4408 Iyar Way, Wake Forest, NC 27587-4166 | 2015-09-17 |
| 1396111837 | Mcguinn Home | Psychiatric Residential Treatment Facility | 16 Columbia Cir, Hendersonville, NC 28792-7005 | 2015-08-19 |
| Find all providers with the same taxonomy | ||||
| City | WASHINGTON |
| Zip Code | 27889 |
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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.