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General NPI Number Information
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NPI Number | 1588591556
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Entity Type | Organization
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Legal Business Name | COUNTRY LIVING LLC
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Dates
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Enumeration Date | 05/05/2026
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Last Update Date | 05/05/2026
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Provider Practice Location Address
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Address Line | 5809 HIGHWAY 2 STE 101A
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City | PRIEST RIVER
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State | ID
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Zip | 83856-6097
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Country | US
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Telephone | 509-671-0212
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Fax |
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Provider Business Mailing Address
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Address Line | 92 YARROW LN
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City | NEWPORT
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State | WA
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Zip | 99156-9122
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Country | US
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Telephone | 509-671-0212
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | KAWAI L TOWRY
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Credential |
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Telephone | 509-671-0212
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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