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General NPI Number Information
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NPI Number | 1023726437
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Entity Type | Organization
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Legal Business Name | PEACEFUL HEARTS ENTERPRISE INC
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Dates
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Enumeration Date | 11/14/2022
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Last Update Date | 12/12/2022
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Provider Practice Location Address
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Address Line | 5238 L J MARTIN DR
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City | GAINESVILLE
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State | GA
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Zip | 30507-8706
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Country | US
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Telephone | 770-330-5729
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Fax | 678-828-7219
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Provider Business Mailing Address
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Address Line | 5238 L J MARTIN DR
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City | GAINESVILLE
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State | GA
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Zip | 30507-8706
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Country | US
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Telephone | 177-033-0572
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Fax | 678-828-7219
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MRS. DENA M BROWN
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Credential |
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Telephone | 770-330-5729
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number |
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License Number State |
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