Type 2 · Organization ✓ Active NPI ✓ Valid NPI checksum

Country Living Guest Home, Inc.

Intellectual and/or Developmental Disabilities Residential Treatment Facility in Washington, NC · enumerated 2012 · authorized official Kellie Hardison, Administrator.

Data current as of Jul 13, 2026 · sourced from CMS NPPES

National Provider Identifier

1104182005

Verified

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Registry record

Entity type Organization (Type 2)

Legal business name Country Living Guest Home, Inc.

Other name <Unavail>

Practice address 618 Plant St, Washington, NC, 27889

Phone (252) 975-3741

Fax (252) 975-3044

Enumeration date Apr 4, 2012

Last updated in NPPES Oct 12, 2023

Taxonomy & classification

251S00000X Community/Behavioral Health Agency Agencies Secondary

311ZA0620X Adult Care Home Facility Nursing & Custodial Care Facilities Secondary

320600000X Intellectual and/or Developmental Disabilities Residential Treatment Facility Residential Treatment Facilities Primary

343900000X Non-emergency Medical Transport (VAN) Transportation Services Secondary

Authorized official

Name Kellie Hardison

Title Administrator

Phone (252) 975-3741

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes, even if the provider moves or changes specialty.

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Frequently asked questions

How current is this record?

Data comes from the CMS NPPES public dissemination file; this record was last updated in NPPES on 2023-10-12. Verify at npiregistry.cms.hhs.gov.

Where is Country Living Guest Home, Inc. located?

The practice location on file with NPPES is in Washington, NC.

Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2023-10-12.