Country Homes LLC

Primary specialty

Adult Care Home FacilityTaxonomy code 311ZA0620X

Legal business name

COUNTRY HOMES LLC

Practice address

2619 SW 320TH PL
Federal Way, WA 98023-2268

Phone

(206) 712-0398

Fax

(253) 587-9081

NPI assigned

May 16, 2024

Last updated

May 16, 2024By 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

Binta Wangui Gathogo

Title

Owner

Phone

(206) 712-0398

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1715817600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1715817600000",
    "number": "1598514143",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2619 SW 320TH PL",
            "city": "FEDERAL WAY",
            "state": "WA",
            "postal_code": "980232268",
            "telephone_number": "206-712-0398",
            "fax_number": "253-587-9081"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2619 SW 320TH PL",
            "city": "FEDERAL WAY",
            "state": "WA",
            "postal_code": "980232268",
            "telephone_number": "206-712-0398",
            "fax_number": "253-587-9081"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COUNTRY HOMES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-05-16",
        "last_updated": "2024-05-16",
        "certification_date": "2024-05-15",
        "status": "A",
        "authorized_official_last_name": "GATHOGO",
        "authorized_official_first_name": "BINTA",
        "authorized_official_middle_name": "WANGUI",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "206-712-0398"
    },
    "taxonomies": [
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2024; 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.