Peaceful Care House

Primary specialty

Intellectual and/or Developmental Disabilities Residential Treatment FacilityTaxonomy code 320600000X

License

0312-513850-0803-P Issued in OR

Legal business name

PEACEFUL CARE HOUSE

Practice address

10254 SE Isaac Dr
Happy Valley, OR 97086-7159

Phone

(503) 760-4262

Fax

(503) 762-2186

NPI assigned

Aug 6, 2009

Last updated

Aug 6, 2009By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Miss Estera Bodale

Title

Care Provider

Phone

(503) 760-4262

Specialties & licenses 2

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1249516800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1249516800000",
    "number": "1033340096",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10254 SE ISAAC DR",
            "city": "HAPPY VALLEY",
            "state": "OR",
            "postal_code": "970867159",
            "telephone_number": "503-760-4262",
            "fax_number": "503-762-2186"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10254 SE ISAAC DR",
            "city": "HAPPY VALLEY",
            "state": "OR",
            "postal_code": "970867159",
            "telephone_number": "503-760-4262",
            "fax_number": "503-762-2186"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEACEFUL CARE HOUSE",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-08-06",
        "last_updated": "2009-08-06",
        "status": "A",
        "authorized_official_last_name": "BODALE",
        "authorized_official_first_name": "ESTERA",
        "authorized_official_title_or_position": "CARE PROVIDER",
        "authorized_official_telephone_number": "503-760-4262",
        "authorized_official_name_prefix": "Miss"
    },
    "taxonomies": [
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "OR",
            "license": "0312-513850-0803-P",
            "primary": true
        },
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "OR",
            "license": "03125138500803P",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Taylor Lee Patterson, PT, DPT
• Paula M Crone, DO PC
• Jeffrey P Pavelka, DO
• Katharine Payne, FNP
• Robert Timothy Pea, CADC
• Peacehealth Networks on Demand, LLC (ZoomCare Happy Valley)
• Anna Christine Peaslee
• Adam Peterson, QMHP
• Heather Peterson
• Kevin Gia-Minh Phan, OD

• Intellectual and/or Developmental Disabilities Residential Treatment Facility in Happy Valley, OR
• Providers in Happy Valley, OR by specialty
• Intellectual and/or Developmental Disabilities Residential Treatment Facility in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.