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COUNTRY LIVING ASSISTED LIVING
NPI 1275811333
Assisted Living Facility in Mountain Grove, MO

Active since July 23, 2011CLIA 26D2029771 · Waiver
2820 N MAIN AVE, MOUNTAIN GROVE, MO 65711(417) 926-1955(417) 926-1951 Get Directions Write a Review

NPPES record last updated: August 29, 2011. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Country Living Assisted Living NPPES

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

COUNTRY LIVING ASSISTED LIVING (NPI 1275811333) is a healthcare organization registered as an assisted living facility in Mountain Grove, Missouri and active in the NPI registry since July 2011. The organization holds a CLIA Waiver certificate valid through March 22, 2028 and lists Joseph Walter Golden, Owner/management, as its authorized official.

NPPES Registry Identity

NPI1275811333
Entity TypeOrganization
Primary Taxonomy310400000X
Legal Business NameCOUNTRY LIVING CARE HOMES LLC
Location Address2820 N MAIN AVEMountain Grove, MO 65711-1403
Mailing AddressPo Box 649Mountain Grove, MO 65711-0649 · (417) 926-1955 · Fax (417) 926-1951
Phone(417) 926-1955
Fax(417) 926-1951
Organization SubpartNo
Authorized OfficialJoseph Walter GoldenOwner/management · (417) 926-1955
Enumeration DateJuly 23, 2011
Last NPPES UpdateAugust 29, 2011
✔ NPI 1275811333 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyAssisted Living FacilityNursing & Custodial Care Facilities
Taxonomy Code310400000X
License✔ Licensed in MO · 039387
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.
2820 N MAIN AVE, Mountain Grove, MO 65711
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Other Names 1

Doing Business AsCountry Living Assisted Living

CLIA Laboratory Certificates CMS CLIA

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 26D2029771

Country Living Assisted Living · Mountain Grove, MO
Active · expires Mar 22, 2028
CLIA Number26D2029771
Laboratory TypeAssisted Living Facility
Certificate Effective DateMarch 23, 2026
Certificate Expiration DateMarch 22, 2028
Laboratory DirectorDeanna Thompson
Laboratory Phone(417) 926-1955
Laboratory LocationCountry Living Assisted Living2820 North Main Avenue, Mountain Grove, MO 65711
CLIA data matches this NPI record on: Address 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 Care Homes LLC's NPI number?

The NPI number for Country Living Care Homes LLC is 1275811333. It was assigned to this organization in the NPPES registry on July 23, 2011. The provider is doing business as Country Living Assisted Living.

Where is Country Living Care Homes LLC located?

Country Living Care Homes LLC is located at 2820 N Main Ave, Mountain Grove, MO 65711. The listed phone number is (417) 926-1955.

What is Country Living Care Homes LLC's specialty?

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

Does Country Living Care Homes LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 26D2029771) is associated with this NPI, valid through March 22, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Country Living Care Homes LLC was last updated on August 29, 2011. NPI Profile syncs with the weekly NPPES data releases published by CMS.