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COUNTRYWOOD MANOR ASSISTED LIVING, INC.
NPI 1104429398
Assisted Living Facility in Mantachie, MS

Active since November 19, 2020
145 WATSON DR, MANTACHIE, MS 38855(662) 282-7808(662) 282-7738 Get Directions Write a Review

NPPES record last updated: November 19, 2020. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Countrywood Manor Assisted Living, Inc. NPPES

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

COUNTRYWOOD MANOR ASSISTED LIVING, INC. (NPI 1104429398) is a healthcare organization registered as an assisted living facility in Mantachie, Mississippi and active in the NPI registry since November 2020. The organization lists Kenneth A Long, President, as its authorized official.

NPPES Registry Identity

NPI1104429398
Entity TypeOrganization
Primary Taxonomy310400000X
Legal Business NameCOUNTRYWOOD MANOR ASSISTED LIVING, INC.
Location Address145 WATSON DRMantachie, MS 38855-8381
Mailing AddressPo Box 4150Tupelo, MS 38803-4150 · (662) 322-4636 · Fax (662) 840-3311
Phone(662) 282-7808
Fax(662) 282-7738
Organization SubpartNo
Authorized OfficialKenneth A LongPresident · (662) 401-8930
Enumeration DateNovember 19, 2020
NPPES CertifiedNovember 19, 2020
✔ NPI 1104429398 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyAssisted Living FacilityNursing & Custodial Care Facilities
Taxonomy Code310400000X
Definition
A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being.
145 WATSON DR, Mantachie, MS 38855
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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 Countrywood Manor Assisted Living, Inc.'s NPI number?

The NPI number for Countrywood Manor Assisted Living, Inc. is 1104429398. It was assigned to this organization in the NPPES registry on November 19, 2020.

Where is Countrywood Manor Assisted Living, Inc. located?

Countrywood Manor Assisted Living, Inc. is located at 145 Watson Dr, Mantachie, MS 38855. The listed phone number is (662) 282-7808.

What is Countrywood Manor Assisted Living, Inc.'s specialty?

The primary specialty registered for this NPI is Assisted Living Facility with taxonomy code 310400000X.

When was this NPI record last updated?

The NPPES record for Countrywood Manor Assisted Living, Inc. was last updated on November 19, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.