Country Living Guest Home, Inc.
NPI 1558428045 · Intellectual and/or Developmental Disabilities Residential Treatment Facility · Washington, NC
Country Living Guest Home, Inc. is a Intellectual and/or Developmental Disabilities Residential Treatment Facility organization in Washington, NC (NPI 1558428045).
Provider details
- NPI number
- 1558428045
- Entity type
- Organization
- Primary specialty
- Intellectual and/or Developmental Disabilities Residential Treatment FacilityResidential Treatment Facilities
- Parent organization
- Country Living Guest Home, Inc.
- Organization subpart
- Yes
- Authorized official
- Kellie Hardison, Administrator(252) 975-3741
Specialties & taxonomies
Residential Treatment Facilities
- Community/Behavioral Health Agency251S00000X
Agencies
- Adult Care Home Facility311ZA0620X
Nursing & Custodial Care Facilities
- Non-emergency Medical Transport (VAN)343900000X
Transportation Services
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
19 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Other names (DBA / former)
- Doing business as
- Country Living Guest Home #2
Registry dates
- Enumerated
- 2007-01-03
- Last updated
- 2023-07-27
- Certified
- 2023-07-27
Frequently asked questions
- What is Country Living Guest Home, Inc.'s NPI number?
- Country Living Guest Home, Inc.'s National Provider Identifier (NPI) is 1558428045, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Country Living Guest Home, Inc.?
- Country Living Guest Home, Inc. is classified in the NPPES registry as Intellectual and/or Developmental Disabilities Residential Treatment Facility (Residential Treatment Facilities).
- Where is Country Living Guest Home, Inc. located?
- Country Living Guest Home, Inc.'s practice location on file with NPPES is 3052 Market Street Extension, Washington, NC 27889-8126.
- What is Country Living Guest Home, Inc.'s phone number?
- The practice phone number listed in the NPPES registry for Country Living Guest Home, Inc. is (252) 975-3741.
- Who is the authorized official for Country Living Guest Home, Inc.?
- The authorized official listed on Country Living Guest Home, Inc.'s NPPES record is Kellie Hardison, Administrator. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Country Living Guest Home, Inc.'s NPI active?
- Yes — Country Living Guest Home, Inc.'s NPI (1558428045) is active in the NPPES registry as of the last update on 2023-07-27.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.