COUNTRY GROVE HOME LLC
NPI 1306162706
Assisted Living Facility - Assisted Living, Mental Illness in Necedah, WI

Q: What is Country Grove Home LLC's NPI number?

The NPI number for Country Grove Home LLC is 1306162706. It was assigned to this organization in the NPPES registry on April 12, 2010.

Q: What is Country Grove Home LLC's specialty?

The primary specialty registered for this NPI is Assisted Living Facility, specializing in Assisted Living, Mental Illness, with taxonomy code 3104A0625X.

Active since April 12, 2010

N11151 17TH AVE, NECEDAH, WI 54646(608) 565-2735 Get Directions Write a Review

NPPES record last updated: April 12, 2010. Verified against the NPPES registry weekly; last sync: August 02, 2026.

On this page

About Country Grove Home Llc NPPES

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

COUNTRY GROVE HOME LLC (NPI 1306162706) is a healthcare organization registered as an assisted living, mental illness in Necedah, Wisconsin and active in the NPI registry since April 2010. The organization lists Scott A Peak, Owner, as its authorized official.

NPPES Registry Identity

NPI1306162706

Entity TypeOrganization

Primary Taxonomy3104A0625X

Legal Business NameCOUNTRY GROVE HOME LLC

Location AddressN11151 17TH AVENecedah, WI 54646-7619

Mailing AddressN10414 18th AveNecedah, WI 54646-7934 · (608) 547-2752

Phone(608) 565-2735

Organization SubpartNo

Authorized OfficialScott A PeakOwner · (608) 547-2755

Enumeration DateApril 12, 2010

✔ NPI 1306162706 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyAssisted Living Facility · Assisted Living, Mental IllnessNursing & Custodial Care Facilities

Taxonomy Code3104A0625X

License✔ Licensed in WI · 0011011

Definition

A facility providing supportive services to individuals who can function independently in most areas of activity, but need special guidance, assistance and/or monitoring as the result of a psychiatric problem. This type of facility requires a staff with special training in mental health training and dealing with psychiatric emergencies.

N11151 17TH AVE, Necedah, WI 54646

Open in Google Maps ↗

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 Grove Home LLC's NPI number?

The NPI number for Country Grove Home LLC is 1306162706. It was assigned to this organization in the NPPES registry on April 12, 2010.

Where is Country Grove Home LLC located?

Country Grove Home LLC is located at N11151 17th Ave, Necedah, WI 54646. The listed phone number is (608) 565-2735.

What is Country Grove Home LLC's specialty?

The primary specialty registered for this NPI is Assisted Living Facility, specializing in Assisted Living, Mental Illness, with taxonomy code 3104A0625X.

When was this NPI record last updated?

The NPPES record for Country Grove Home LLC was last updated on April 12, 2010. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 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.