Healthcare Provider Details

I. General information

NPI: 1275331985
Provider Name (Legal Business Name): P.E.A.K. ADULT DAY SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/06/2025
Last Update Date: 03/11/2025
Certification Date: 03/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23220 CHAGRIN BLVD APT 289
BEACHWOOD OH
44122-5440
US

IV. Provider business mailing address

23220 CHAGRIN BLVD APT 289
BEACHWOOD OH
44122-5440
US

V. Phone/Fax

Practice location:
  • Phone: 216-210-9577
  • Fax:
Mailing address:
  • Phone: 216-210-9577
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: RACINE DOWNEY
Title or Position: CEO
Credential:
Phone: 216-210-9577