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COUNTRY CLUB REST HOME
NPI 1790825354
Lodging in Randleman, NC

Active since February 06, 2007
1324 COLTRANE MILL RD, RANDLEMAN, NC 27317(336) 574-6293 Get Directions Write a Review

NPPES record last updated: August 22, 2020. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Country Club Rest Home NPPES

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

COUNTRY CLUB REST HOME (NPI 1790825354) is a healthcare organization registered as a lodging in Randleman, North Carolina and active in the NPI registry since February 2007. The organization lists Pearlie M. Bullock, Administrator, as its authorized official.

NPPES Registry Identity

NPI1790825354
Entity TypeOrganization
Primary Taxonomy177F00000X
Legal Business NameTRIAD TELECARE, INC.
Location Address1324 COLTRANE MILL RDRandleman, NC 27317-8020
Mailing Address1328 Coltrane Mill RdRandleman, NC 27317-8020 · (336) 674-6293
Phone(336) 574-6293
Organization SubpartNo
Authorized OfficialPearlie M. BullockAdministrator · (336) 674-6293
Enumeration DateFebruary 6, 2007
Last NPPES UpdateAugust 22, 2020
✔ NPI 1790825354 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyLodgingOther Service Providers
Taxonomy Code177F00000X
License✔ Licensed in NC · HAL076008
Definition
A public or privately owned facility providing overnight lodging to individuals traveling long distances or receiving prolonged outpatient medical services away from home.
1324 COLTRANE MILL RD, Randleman, NC 27317
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Other Names 1

Doing Business AsCountry Club Rest Home

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

TRIAD TELECARE, INC.
Case Manager/Care Coordinator
1324 COLTRANE MILL RD
RANDLEMAN, NC 27317
Randolph County (336) 674-6293
MR. CARTER LEE SHOTWELL LCSW-A
Social Worker (Clinical)
1324 COLTRANE MILL RD
RANDLEMAN, NC 27317
Randolph County (336) 674-6293

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 Triad Telecare, Inc.'s NPI number?

The NPI number for Triad Telecare, Inc. is 1790825354. It was assigned to this organization in the NPPES registry on February 6, 2007. The provider is doing business as Country Club Rest Home.

Where is Triad Telecare, Inc. located?

Triad Telecare, Inc. is located at 1324 Coltrane Mill Rd, Randleman, NC 27317. The listed phone number is (336) 574-6293.

What is Triad Telecare, Inc.'s specialty?

The primary specialty registered for this NPI is Lodging with taxonomy code 177F00000X.

When was this NPI record last updated?

The NPPES record for Triad Telecare, Inc. was last updated on August 22, 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.