MEDICARE: PEACEFUL STAY LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	3104A0625X	Assisted Living Facility (Mental Illness)
2	311500000X	Alzheimer Center (Dementia Center)
3	311ZA0620X	Adult Care Home Facility
4	315D00000X	Inpatient Hospice
5	310400000X	Assisted Living Facility

General Provider Information

NPI Number	:	1992657050
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PEACEFUL STAY LLC

Provider Business Mailing Address
First Line	:	800 E 82ND ST
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90001-3224
Country	:	US
Telephone Number	:	213-306-8386
Fax Number	:

Provider Business Practice Location Address
First Line	:	800 E 82ND ST
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90001-3224
Country	:	US
Telephone Number	:	213-306-8386
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	TYRONE MCGEE
Credential	:
Telephone Number	:	310-963-7288

Provider Enumeration Date	:	02/11/2026
Last Update Date	:	02/11/2026

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Directions to “PEACEFUL STAY LLC ” Practice Location

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