=====================================================
General NPI Number Information
=====================================================
NPI Number | 1801720602
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | COUNTRY LIVING INHOME CARE LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/09/2026
-----------------------------------------------------
Last Update Date | 06/10/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 5809 HIGHWAY 2 STE 101
-----------------------------------------------------
City | PRIEST RIVER
-----------------------------------------------------
State | ID
-----------------------------------------------------
Zip | 83856-6097
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 208-469-2122
-----------------------------------------------------
Fax | 208-428-4797
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 92 YARROW LN
-----------------------------------------------------
City | NEWPORT
-----------------------------------------------------
State | WA
-----------------------------------------------------
Zip | 99156-9122
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 509-671-0212
-----------------------------------------------------
Fax | 208-428-4797
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | KAWAI LEA TOWRY
-----------------------------------------------------
Credential | NAC
-----------------------------------------------------
Telephone | 208-469-2123
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 253Z00000X
-----------------------------------------------------
Taxonomy Name | In Home Supportive Care Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------