MEDICARE: PEACEHOUSE LIVING FACILITIES

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	311ZA0620X	Adult Care Home Facility

General Provider Information

NPI Number	:	1558211326
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PEACEHOUSE LIVING FACILITIES

Provider Business Mailing Address
First Line	:	300 SPARROW DR
Second Line	:
City	:	FAYETTEVILLE
State	:	NC
Zip	:	28306-8227
Country	:	US
Telephone Number	:	910-638-9564
Fax Number	:

Provider Business Practice Location Address
First Line	:	300 SPARROW DR
Second Line	:
City	:	FAYETTEVILLE
State	:	NC
Zip	:	28306-8227
Country	:	US
Telephone Number	:	910-638-9564
Fax Number	:

Authorized Official
Title or Position	:	CEO/ADMINISTRATOR
Name	:	MRS. STACEY HURST
Credential	:
Telephone Number	:	910-638-9564

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

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