Peaceful Group Home LLC

Primary specialty

In Home Supportive Care AgencyTaxonomy code 253Z00000X

Legal business name

PEACEFUL GROUP HOME LLC

Practice address

1476 Bentree Dr SE
Grand Rapids, MI 49508-7398

Phone

(614) 368-3657

NPI assigned

Nov 6, 2024

Organization subpart

No

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

Authorized official

Name

Gentille Mwiza

Title

Owner/Director

Phone

(614) 368-3657

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1730851200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1730851200000",
    "number": "1073336194",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1476 BENTREE DR SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495087398"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1476 BENTREE DR SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495087398",
            "telephone_number": "614-368-3657"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEACEFUL GROUP HOME LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-11-06",
        "last_updated": "2024-11-06",
        "certification_date": "2024-11-06",
        "status": "A",
        "authorized_official_last_name": "MWIZA",
        "authorized_official_first_name": "GENTILLE",
        "authorized_official_title_or_position": "OWNER/DIRECTOR",
        "authorized_official_telephone_number": "614-368-3657"
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Natalie Anna Payne, MD
• Robert Craig Payne, D.D.S.
• Thea Pazdernik
• Pca-Corrections LLC
• Peace Love Counseling, LLC
• Peaceful Homecare LLC
• Cynthia Elizabeth Louise Peacock, MD
• Daniel Peacock, MSW
• Devarri E Peacock
• Samuel Peacock, PHYSICIAN ASSISTANT

• In Home Supportive Care Agency in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• In Home Supportive Care Agency in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 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.