| NPI | 1760094122 |
|---|---|
| Doing Business As | COUNTRYSIDE LIVING |
| Entity Type | Organization |
| Authorized Contact | VERONNICA J SMITH Administrator 605-996-1991 |
| Organization Subpart ? | No |
| Primary Taxonomy | 310400000X Assisted Living Facility |
| Enumeration Date | 2020-08-18 |
| Last Update Date | 2020-08-18 |