Countryside Home Inc.

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

COUNTRYSIDE HOME INC.

Practice address

2454 Highway 15
Abilene, KS 67410-6084

Phone

(785) 576-1607

Fax

(785) 263-9885

NPI assigned

Jan 14, 2025

Last updated

Jan 14, 2025By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Andrew Still, RN, BSN

Title

System Administrator

Phone

(719) 232-3208

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1736812800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1736812800000",
    "number": "1063223683",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2454 HIGHWAY 15",
            "city": "ABILENE",
            "state": "KS",
            "postal_code": "674106084",
            "telephone_number": "785-576-1607"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2454 HIGHWAY 15",
            "city": "ABILENE",
            "state": "KS",
            "postal_code": "674106084",
            "telephone_number": "785-576-1607",
            "fax_number": "785-263-9885"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COUNTRYSIDE HOME INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-01-14",
        "last_updated": "2025-01-14",
        "certification_date": "2025-01-14",
        "status": "A",
        "authorized_official_last_name": "STILL",
        "authorized_official_first_name": "ANDREW",
        "authorized_official_title_or_position": "SYSTEM ADMINISTRATOR",
        "authorized_official_telephone_number": "719-232-3208",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "RN, BSN"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jenna Clark, LSCSW
• Justin B Clark, LAT, ATC
• Danya R Cole, CPTA
• Lawrence M Cooper, DDS
• Countryside Home Inc
• County of Dickinson Office of County Clerk
• County of Dickinson Office of County Clerk (Dickinson County EMS)
• Cuba Chiropractic PA
• Michael J. Cuba, DC
• Chantell Renee Debenham, ARNP

• Assisted Living Facility in Abilene, KS
• Providers in Abilene, KS by specialty
• Assisted Living Facility in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.