A residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with developmental and intellectual disabilities and are not able to live independently.
| Specialty | Taxonomy Code | |
|---|---|---|
| * | Residential Treatment Facility, Intellectual and/or Developmental Disabilities | 320600000X |
| Adult Care Home | 311ZA0620X | |
| Community/Behavioral Health | 251S00000X |
* Indicates primary specialty
| NPI Number | 1952615825 |
| Legal business name LBN |
COUNTRY LIVING GUEST HOME, INC. |
| Authorized official | KELLIE HARDISON - (ADMINISTRATOR) |
| Entity | Organization |
| Organization subpart | No |
| Enumeration date | 08/03/2010 |
| Last updated | 11/21/2023 - About 3 years ago |
| Sole proprietor1 | Not specified |
| Identifiers | n/a |
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.
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