Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Country Living Guest Home, Inc

Organization Community/Behavioral Health Agency · NPI 1104182005

Country Living Guest Home, Inc is a Community/Behavioral Health Agency in Washington, North Carolina. Registered with an NPI since 2012.

In the registry since
2012
Specialties on file
4
What do these letters mean?
Inc — Incorporated
A form of business registration, not a clinical qualification.

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Practice location Address checks out

618 Plant St
Washington, NC 27889
Phone: (252) 975-3741
Fax: (252) 975-3044
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Intellectual and/or Developmental Disabilities Residential Treatment Facility (primary) Taxonomy 320600000X
Community/Behavioral Health Agency Taxonomy 251S00000X
Adult Care Home Facility Taxonomy 311ZA0620X
Non-emergency Medical Transport (VAN) Taxonomy 343900000X

Record details

NPI number1104182005
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Kellie Hardison — Administrator · (252) 975-3741
Other names Country Living Guest Home #8
NPI enumeratedApril 4, 2012
Last updated in NPPESOctober 12, 2023
Certification dateJune 3, 2020
Mailing address217 East 9th Street, Washington, NC 27889

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