Peaceful River Residential Services

Primary specialty

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

License

CLA001207 Issued in GA

Legal business name

PEACEFUL RIVER RESIDENTIAL SERVICES

Practice address

746 Rudgate Rd
Columbus, GA 31904-2929

Phone

(706) 571-8859

Fax

(706) 243-6357

NPI assigned

Mar 1, 2016

Organization subpart

No

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

Authorized official

Name

Pamela S Williams

Title

Owner

Phone

(706) 681-4211

Specialties & licenses 1

Addresses

Other identifiers 1

Tax ID family

Peaceful River Home Care Agency2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Peaceful River Home Care Agency

  • In Home Supportive Care Agency
  • Columbus, GA
  • NPI 1952759219
  NPD tax ID

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

{
    "created_epoch": "1456790400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1456790400000",
    "number": "1093175283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "746 RUDGATE RD",
            "city": "COLUMBUS",
            "state": "GA",
            "postal_code": "319042929",
            "telephone_number": "706-571-8859",
            "fax_number": "706-243-6357"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "746 RUDGATE RD",
            "city": "COLUMBUS",
            "state": "GA",
            "postal_code": "319042929",
            "telephone_number": "706-571-8859",
            "fax_number": "706-243-6357"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEACEFUL RIVER RESIDENTIAL SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-03-01",
        "last_updated": "2016-03-01",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "PAMELA",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "706-681-4211"
    },
    "taxonomies": [
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "GA",
            "license": "CLA001207",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003136088A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tabatha Diane Paulson, APRN-BC/ FNP-C
• Brian Pawlowski, FNP-C
• Latanja Peabody
• Peace and Prosperity Counseling Services, LLC
• Peaceful River Home Care Agency
• Peach Gardens Private Home Care
• Kimberly H Peacock
• Leslie Peacock, PHARMD
• Bret Kyle Pearce, D.O.
• Carol Pearson, CNNP

• Intellectual and/or Developmental Disabilities Residential Treatment Facility in Columbus, GA
• Providers in Columbus, GA by specialty
• Intellectual and/or Developmental Disabilities Residential Treatment Facility in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2016; 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.