| NPI | 1730845322 |
|---|---|
| Doing Business As | COUNTRYSIDE HAVEN ALF |
| Entity Type | Organization |
| Authorized Contact | DENIS LUBINGA President 240-640-1583 |
| Organization Subpart ? | No |
| Primary Taxonomy | 310400000X Assisted Living Facility |
| Enumeration Date | 2021-11-09 |
| Last Update Date | 2025-02-05 |