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General NPI Number Information
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NPI Number | 1043755978
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Entity Type | Organization
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Legal Business Name | PEACEFUL LIVING HOME CARE, LLC
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Dates
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Enumeration Date | 01/02/2017
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Last Update Date | 01/02/2017
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Provider Practice Location Address
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Address Line | 610 UPWEY CT
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City | ROLESVILLE
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State | NC
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Zip | 27571-9218
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Country | US
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Telephone | 855-658-1670
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Fax | 855-658-1674
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Provider Business Mailing Address
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Address Line | PO BOX 616
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City | ROLESVILLE
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State | NC
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Zip | 27571-0616
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Country | US
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Telephone | 855-658-1670
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Fax | 855-658-1674
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Authorized Official
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Title or Position | OWNER
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Name | MR. JAMES I MILLER JR.
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Credential |
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Telephone | 855-658-1670
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 385HR2050X
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Taxonomy Name | Respite Care Camp
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License Number | HC4854
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License Number State | NC
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