| NPI | 1235668625 |
|---|---|
| Doing Business As | COUNTRY MANOR ASSISTED LIVING |
| Entity Type | Organization |
| Authorized Contact | REBECCA JOHNSON Owner/Manager 936-776-0703 |
| Organization Subpart ? | No |
| Primary Taxonomy | 310400000X Assisted Living Facility |
| Enumeration Date | 2017-06-08 |
| Last Update Date | 2022-07-21 |