Country Home Assisted Living LLC Dba Country Home

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

23040Q Issued in CO

Legal business name

COUNTRY HOME ASSISTED LIVING LLC DBA COUNTRY HOME

Practice address

1425 Debbie Cir
Parker, CO 80138-4702

Phone

(303) 840-1986

NPI assigned

Jan 27, 2016

Organization subpart

No

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

Authorized official

Name

Linda Christine Melbardis

Title

Owner

Phone

(303) 840-1986

Specialties & licenses 1

Addresses

Other names 1

• Country Home Doing business as

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

{
    "created_epoch": "1453852800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1620086400000",
    "number": "1376900811",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1425 DEBBIE CIR",
            "city": "PARKER",
            "state": "CO",
            "postal_code": "801384702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1425 DEBBIE CIR",
            "city": "PARKER",
            "state": "CO",
            "postal_code": "801384702",
            "telephone_number": "303-840-1986"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COUNTRY HOME ASSISTED LIVING LLC DBA COUNTRY HOME",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-01-27",
        "last_updated": "2021-05-04",
        "certification_date": "2021-04-24",
        "status": "A",
        "authorized_official_last_name": "MELBARDIS",
        "authorized_official_first_name": "LINDA",
        "authorized_official_middle_name": "CHRISTINE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "303-840-1986"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "CO",
            "license": "23040Q",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Country Home",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Country Home",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Assisted Living Facility in Parker, CO
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• Assisted Living Facility in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2021; 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.