Peaceful Abode Afh LLC

Primary specialty

Adult Care Home FacilityTaxonomy code 311ZA0620X

Legal business name

PEACEFUL ABODE AFH LLC

Practice address

19607 Heinz PL
Lynnwood, WA 98036-5825

Phone

(425) 510-4060

Fax

(425) 500-1159

NPI assigned

Jul 19, 2024

Organization subpart

No

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

Authorized official

Name

Lamin Gassama

Title

Administrator

Phone

(206) 552-3004

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1721347200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1721347200000",
    "number": "1063250207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19607 HEINZ PL",
            "city": "LYNNWOOD",
            "state": "WA",
            "postal_code": "980365825",
            "telephone_number": "425-510-4060",
            "fax_number": "425-500-1159"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19607 HEINZ PL",
            "city": "LYNNWOOD",
            "state": "WA",
            "postal_code": "980365825",
            "telephone_number": "425-510-4060",
            "fax_number": "425-500-1159"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEACEFUL ABODE AFH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-07-19",
        "last_updated": "2024-07-19",
        "certification_date": "2024-07-19",
        "status": "A",
        "authorized_official_last_name": "GASSAMA",
        "authorized_official_first_name": "LAMIN",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "206-552-3004"
    },
    "taxonomies": [
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Romalyn Joya Patummas, D.P.T.
• Elizabeth Grace Rodriguez Paul
• Tiffany I Pavesi, PHARM.D.
• Harrison Abraham Payne
• Rahmari Y Payne
• Peacehealth Networks on Demand, LLC
• Pearle Vision Inc
• Angela Lynn Pearson, LSWAIC, LAAC, SUDP,
• Jeffrey James Pearson, D.M.D.
• Ryan Thomas Pederson, ARNP

• Adult Care Home Facility in Lynnwood, WA
• Providers in Lynnwood, WA by specialty
• Adult Care Home Facility in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2024; 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.