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General NPI Number Information
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NPI Number | 1831483833
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Entity Type | Organization
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Legal Business Name | PEACOCK ACRES INC.
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Dates
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Enumeration Date | 06/07/2011
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Last Update Date | 06/07/2011
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Provider Practice Location Address
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Address Line | 838 S MAIN ST STE A
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City | SALINAS
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State | CA
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Zip | 93901-2408
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Country | US
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Telephone | 831-754-3635
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Fax | 831-754-4733
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Provider Business Mailing Address
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Address Line | 838 S MAIN ST STE A
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City | SALINAS
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State | CA
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Zip | 93901-2408
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Country | US
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Telephone | 831-754-3635
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Fax | 831-754-4733
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MR. ERNEST HOWARD
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Credential |
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Telephone | 831-663-5658
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 320800000X
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Taxonomy Name | Mental Illness Community Based Residential Treatment Facility
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License Number |
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License Number State |
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