Country Living Care Homes LLC
NPI #1275811333 in Mountain Grove, Missouri
Provider Information
- NPI Number
- 1275811333
- Entity Type
- Organization
- Organization Name
- Country Living Care Homes LLC
- Primary Specialty
- Assisted Living Facility
- Enumeration Date
- Jul 23, 2011
- Last Updated
- Aug 29, 2011
Practice Location
- Address
- 2820 N MAIN AVE
- City
- Mountain Grove
- State
- Missouri
- ZIP Code
- 65711-1403
- Phone
- (417) 926-1955
Authorized Official
- Name
- MR. JOSEPH WALTER GOLDEN
- Title
- OWNER/MANAGEMENT
- Phone
- (417) 926-1955
Specialties & Taxonomy Codes
| Specialty |
|---|
| Assisted Living Facility |
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