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COUNTRY LIVING GUEST HOME #8
NPI 1104182005
Residential Treatment Facility, Intellectual and/or Developmental Disabilities in Washington, NC

Active since April 04, 2012CLIA Certified · 9 labs
618 PLANT ST, WASHINGTON, NC 27889(252) 975-3741(252) 975-3044 Get Directions Write a Review

NPPES record last updated: October 12, 2023. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Oct 12, 2023, Jun 3, 2020 (2 updates tracked since 2020).

About Country Living Guest Home #8 NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

COUNTRY LIVING GUEST HOME #8 (NPI 1104182005) is a healthcare organization registered as a residential treatment facility, intellectual and/or developmental disabilities in Washington, North Carolina and active in the NPI registry since April 2012. The organization holds 9 active CLIA laboratory certificates and lists Kellie Michelle Hardison, Administrator, as its authorized official.

NPPES Registry Identity

NPI1104182005
Entity TypeOrganization
Primary Taxonomy320600000X
Legal Business NameCOUNTRY LIVING GUEST HOME, INC.
Location Address618 PLANT STWashington, NC 27889
Mailing Address217 East 9th StreetWashington, NC 27889 · (252) 975-3741 · Fax (252) 975-3044
Phone(252) 975-3741
Fax(252) 975-3044
Organization SubpartNo
Authorized OfficialKellie Michelle HardisonAdministrator · (252) 975-3741
Enumeration DateApril 4, 2012
Last NPPES UpdateOctober 12, 20232 updates tracked since enumeration
NPPES CertifiedJune 3, 2020
✔ NPI 1104182005 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 4

★ Primary SpecialtyResidential Treatment Facility, Intellectual and/or Developmental DisabilitiesResidential Treatment Facilities
Taxonomy Code320600000X
Definition
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.
Also ListedCommunity/Behavioral HealthTaxonomy 251S00000X
Also ListedCustodial Care Facility · Adult Care HomeTaxonomy 311ZA0620X
Also ListedNon-emergency Medical Transport (VAN)Taxonomy 343900000X
618 PLANT ST, Washington, NC 27889
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Other Names 1

Doing Business AsCountry Living Guest Home #8

CLIA Laboratory Certificates CMS CLIA 9

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 34D2086748

Country Living Guest Home, Inc #8 · Washington, NC
Active · expires May 26, 2027
CLIA Number34D2086748
Laboratory TypeSupervised Living 5600C
Certificate Effective DateMay 27, 2025
Certificate Expiration DateMay 26, 2027
Laboratory DirectorKellie Hardison
Laboratory Phone(252) 975-3741
Laboratory LocationCountry Living Guest Home, Inc #8618 Plant Street, Washington, NC 27889
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 34D2086749

Country Living Guest Home, Inc · Washington, NC
Active · expires May 26, 2027
CLIA Number34D2086749
Laboratory Type5600A Group Home
Certificate Effective DateMay 27, 2025
Certificate Expiration DateMay 26, 2027
Laboratory DirectorKellie M. Hardison
Laboratory Phone(252) 975-3741
Laboratory LocationCountry Living Guest Home, Inc3094 Market Street Extension, Washington, NC 27889
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 34D2086746

Country Living Guest Home, Inc #2 · Washington, NC
Active · expires Apr 10, 2027
CLIA Number34D2086746
Laboratory TypeSupervised Living 5600C
Certificate Effective DateApril 11, 2025
Certificate Expiration DateApril 10, 2027
Laboratory DirectorKellie Michelle Hardison
Laboratory Phone(252) 975-3741
Laboratory LocationCountry Living Guest Home, Inc #23052 Market Street Extension, Washington, NC 27889
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 34D2086747

Country Living Guest Home, Inc #5 · Washington, NC
Active · expires Apr 10, 2027
CLIA Number34D2086747
Laboratory TypeSupervised Living 5600C
Certificate Effective DateApril 11, 2025
Certificate Expiration DateApril 10, 2027
Laboratory DirectorKellie M. Hardison
Laboratory Phone(252) 975-3741
Laboratory LocationCountry Living Guest Home, Inc #5204 Stewart Drive, Washington, NC 27889
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 34D2321876

Country Living Guest Home #7 · Washington, NC
Active · expires Apr 10, 2027
CLIA Number34D2321876
Laboratory TypeGroup Home
Certificate Effective DateApril 11, 2025
Certificate Expiration DateApril 10, 2027
Laboratory DirectorKellie Michelle Hardison
Laboratory Phone(252) 975-3741
Laboratory LocationCountry Living Guest Home #7207 West 11th Street, Washington, NC 27889
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 34D2321878

Country Living Guest Home #6 · Washington, NC
Active · expires Apr 10, 2027
CLIA Number34D2321878
Laboratory TypeGroup Home
Certificate Effective DateApril 11, 2025
Certificate Expiration DateApril 10, 2027
Laboratory DirectorKellie Michelle Hardison
Laboratory Phone(252) 975-3741
Laboratory LocationCountry Living Guest Home #6252 Dan Taylor Road, Washington, NC 27889
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Country Living Guest Home, Inc.'s NPI number?

The NPI number for Country Living Guest Home, Inc. is 1104182005. It was assigned to this organization in the NPPES registry on April 4, 2012. The provider is doing business as Country Living Guest Home #8.

Where is Country Living Guest Home, Inc. located?

Country Living Guest Home, Inc. is located at 618 Plant St, Washington, NC 27889. The listed phone number is (252) 975-3741.

What is Country Living Guest Home, Inc.'s specialty?

The primary specialty registered for this NPI is Residential Treatment Facility, Intellectual and/or Developmental Disabilities with taxonomy code 320600000X.

Does Country Living Guest Home, Inc. hold CLIA laboratory certificates?

Yes. 9 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.

When was this NPI record last updated?

The NPPES record for Country Living Guest Home, Inc. was last updated on October 12, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.