Country Rest Home, Inc.
Organization Active NPI Nursing Facility/Intermediate Care Facility · Greenwood, DE
NPI 1447477690 · NPPES record last updated Aug 22, 2020
Key facts
- NPI
- 1447477690
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Nursing Facility/Intermediate Care Facility 313M00000X
- License
- 1176 (DE)
- Legal business name
- COUNTRY REST HOME, INC.
- Practice address
- 12046 Sunset LN
Greenwood, DE 19950-4867 - Phone
- (302) 349-4114
- Fax
- (302) 349-4684
- NPI assigned
- Apr 19, 2007
- Organization subpart
- No
Authorized official
- Name
- Beka Troyer
- Title
- Administrative Assistant
- Phone
- (302) 349-4114
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 08D0870495 | Country Rest Home Inc | Certificate of waiver | Aug 31, 2026 |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nursing Facility/Intermediate Care Facility | 313M00000X | 1176 | DE | Yes |
Addresses
Primary practice location
12046 Sunset LN
Greenwood, DE 19950-4867
Mailing address
12046 Sunset LN
Greenwood, DE 19950-4867
Phone (302) 349-4114
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All providers in Greenwood, DE · Nursing Facility/Intermediate Care Facility in Delaware
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 22, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.