Classic Country Living Incorporated

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

117205 Issued in TX

Legal business name

CLASSIC COUNTRY LIVING INCORPORATED

Practice address

109 Savanah Jon Blvd
Boerne, TX 78015-8399

Phone

(830) 336-4040

Fax

(830) 336-4054

NPI assigned

Nov 30, 2006

Organization subpart

No

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

Authorized official

Name

Mrs. Starlette Rose Rogge

Title

Administrator and Manager

Phone

(830) 336-4040

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1164844800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1255408423",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "109 SAVANAH JON BLVD",
            "city": "BOERNE",
            "state": "TX",
            "postal_code": "780158399",
            "telephone_number": "830-336-4040",
            "fax_number": "830-336-4054"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 SAVANAH JON BLVD",
            "city": "BOERNE",
            "state": "TX",
            "postal_code": "780158399",
            "telephone_number": "830-336-4040",
            "fax_number": "830-336-4054"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLASSIC COUNTRY LIVING INCORPORATED",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-30",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ROGGE",
        "authorized_official_first_name": "STARLETTE",
        "authorized_official_middle_name": "ROSE",
        "authorized_official_title_or_position": "ADMINISTRATOR AND MANAGER",
        "authorized_official_telephone_number": "830-336-4040",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "TX",
            "license": "117205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Katherine Martin Cirbo, PSYD
• Joyce K Clair, APN
• Corrie Lynn Clark, RDN, LD
• Joan Macfarlane Clark, L.C.S.W.
• Katie Clark, RN
• Clay Wellness, LLC
• Tracy Clementi, RN
• Sarah Kathryn Clements, PHARMD
• Benny R Cleveland, M.D.
• Clover Care Company, LLC.

• Assisted Living Facility in Boerne, TX
• Providers in Boerne, TX by specialty
• Assisted Living Facility in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.