Country Health Care

Primary specialty

Children's Substance Abuse Rehabilitation FacilityTaxonomy code 3245S0500X

Legal business name

COUNTRY HEALTH CARE

Practice address

4444 N 25TH St Unit 43
Phoenix, AZ 85016-5645

Phone

(602) 363-2743

NPI assigned

Feb 21, 2025

Organization subpart

No

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

Authorized official

Name

Mr. Kenneth Sean Countryman, JD

Title

President

Phone

(602) 363-2743

Specialties & licenses 2

Addresses

Other names 1

• Country healh care Former legal business name

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

{
    "created_epoch": "1740096000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1740096000000",
    "number": "1356147128",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 11077",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852840018",
            "telephone_number": "602-363-2743"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4444 N 25TH ST UNIT 43",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850165645",
            "telephone_number": "602-363-2743"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COUNTRY HEALTH CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-02-21",
        "last_updated": "2025-02-21",
        "certification_date": "2025-02-21",
        "status": "A",
        "authorized_official_last_name": "COUNTRYMAN",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_middle_name": "SEAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "602-363-2743",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "JD"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3245S0500X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Country healh care",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• Alexis Counts
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• County of Maricopa
• County of Maricopa Co Maricopa County Treas Pendergast School Dist 92
• County of Maricopa Creighton Elementary School

• Children's Substance Abuse Rehabilitation Facility in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Children's Substance Abuse Rehabilitation Facility in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 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.