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

Countryside Home, LLC

Organization Assisted Living Facility · NPI 1043520133

Countryside Home, LLC is an Assisted Living Facility in Lebanon, Missouri. Licensed in Missouri. Registered with an NPI since 2010.

Licensed in
MO
In the registry since
2010
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

24499 Park Dr
Lebanon, MO 65536-5843
Phone: (417) 532-7418
Fax: (417) 532-9359
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Assisted Living Facility (primary) Taxonomy 310400000X (MO)

Record details

NPI number1043520133
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Mary Howlett — Owner/Administrator · (417) 532-7418
NPI enumeratedOctober 7, 2010
Last updated in NPPESOctober 7, 2010
Mailing address24499 Park Dr, Lebanon, MO 65536-5843

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