Clean Country Livin LLC

Primary specialty

Lodging ProviderTaxonomy code 177F00000X

Legal business name

CLEAN COUNTRY LIVIN LLC

Practice address

27158 Triton Dr
Spring Branch, TX 78070-5043

Phone

(830) 387-2065

NPI assigned

Dec 18, 2020

Last updated

Dec 18, 2020By 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

Sylvia Black

Title

Director of Billing and Insurance

Phone

(830) 387-2065

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1608249600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1608249600000",
    "number": "1194311639",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27158 TRITON DR",
            "city": "SPRING BRANCH",
            "state": "TX",
            "postal_code": "780705043",
            "telephone_number": "830-387-2065"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27158 TRITON DR",
            "city": "SPRING BRANCH",
            "state": "TX",
            "postal_code": "780705043",
            "telephone_number": "830-387-2065"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLEAN COUNTRY LIVIN LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-12-18",
        "last_updated": "2020-12-18",
        "certification_date": "2020-12-18",
        "status": "A",
        "authorized_official_last_name": "BLACK",
        "authorized_official_first_name": "SYLVIA",
        "authorized_official_title_or_position": "DIRECTOR OF BILLING AND INSURANCE",
        "authorized_official_telephone_number": "830-387-2065"
    },
    "taxonomies": [
        {
            "code": "177F00000X",
            "taxonomy_group": "",
            "desc": "Lodging",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Lodging Provider in Spring Branch, TX
• Providers in Spring Branch, TX by specialty
• Lodging Provider in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2020; 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.