COUNTRY LIVING GUEST HOME #2
NPI 1558428045
Residential Treatment Facility, Intellectual and/or Developmental Disabilities in Washington, NC
NPI Status: Active since January 03, 2007
Contact Information
3052 MARKET STREET EXTENSION
WASHINGTON, NC
ZIP 27889
Phone: (252) 975-3741
Fax: (252) 975-3044
- Organization
- Residential Treatment Facility, Intellec...
About COUNTRY LIVING GUEST HOME #2
This page provides the complete NPI Profile along with additional information for Country Living Guest Home #2, a provider established in Washington, North Carolina operating as a Residential Treatment Facility, Intellectual And/or Developmental Disabilities. The healthcare provider is registered in the NPI registry with number 1558428045 assigned on January 2007. The practitioner's primary taxonomy code is 320600000X. The provider is registered as an organization and their NPI record was last updated 2 years ago. The provider's is doing business as Country Living Guest Home #2. The authorized official of this NPI record is Miss Kellie Michelle Hardison Msw, Lcsw (Administrator)
- NPI
- 1558428045
- Provider Legal Name
- COUNTRY LIVING GUEST HOME, INC.
- Other Organization Name
- COUNTRY LIVING GUEST HOME #2
- Other Name Type
- Doing Business As (3)
- Entity Type
- Organization
- Location Address
- 3052 MARKET STREET EXTENSION WASHINGTON, NC 27889
- Location Phone
- (252) 975-3741
- Location Fax
- (252) 975-3044
- Mailing Address
- 217 EAST 9TH STREET WASHINGTON, NC 27889
- Mailing Phone
- (252) 975-3741
- Mailing Fax
- (252) 975-3044
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- Yes
- Enumeration Date
- 01-03-2007
- Last Update Date
- 07-27-2023
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Residential Treatment Facility, Intellectual and/or Developmental Disabilities
- Taxonomy Code
- 320600000X
- Type
- Residential Treatment Facilities
- Taxonomy Description
- 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.
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 251S00000X | Agencies | Community/Behavioral Health | |
| 2 | 311ZA0620X | Nursing & Custodial Care Facilities | Custodial Care Facility | |
| 3 | 343900000X | Transportation Services | Non-emergency Medical Transport (VAN) |
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| 7804660 | MEDICAID (05) | NC |
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NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 5 | 5 | 8 | 4 | 2 | 8 | 0 | 4 | 5 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 5 | 10 | 8 | 8 | 2 | 16 | 0 | 8 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 5 + 1 + 0 + 8 + 8 + 2 + 1 + 6 + 0 + 8 + 24 = 65 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 70 - 65 = 5 | 5 | ||||||||
The NPI number 1558428045 is valid because the calculated check digit 5 using the Luhn validation algorithm matches the last digit of the original NPI number.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1558428045, enumerated as an "organization" on January 03, 2007.
The provider is located at 3052 MARKET STREET EXTENSION WASHINGTON, NC 27889 and the phone number is (252) 975-3741.
Residential Treatment Facility, Intellectual and/or Developmental Disabilities with taxonomy code 320600000X.
The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.
