MEDICARE: THE GOLDEN PEACE RETREAT

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	251E00000X	Home Health Agency
2	343900000X	Non-emergency Medical Transport (VAN)
3	385H00000X	Respite Care
4	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1598602161
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THE GOLDEN PEACE RETREAT

Provider Business Mailing Address
First Line	:	313 E HUDSON AVE # 1105
Second Line	:
City	:	ROYAL OAK
State	:	MI
Zip	:	48067-3711
Country	:	US
Telephone Number	:	864-314-3023
Fax Number	:

Provider Business Practice Location Address
First Line	:	313 E HUDSON AVE # 1105
Second Line	:
City	:	ROYAL OAK
State	:	MI
Zip	:	48067-3711
Country	:	US
Telephone Number	:	864-314-3023
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	SHANTEL SIMS
Credential	:
Telephone Number	:	864-314-3023

Provider Enumeration Date	:	05/01/2026
Last Update Date	:	05/01/2026

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Directions to “THE GOLDEN PEACE RETREAT ” Practice Location

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