Peach Creek Alf 1 LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

PEACH CREEK ALF 1 LLC

Practice address

1488 Stokes Cir
College Station, TX 77845-8772

Phone

(979) 431-4135

Fax

(855) 662-8109

NPI assigned

Nov 21, 2022

Organization subpart

No

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

Authorized official

Name

Mrs. Rachel Harris, BSN, RN

Title

Owner

Phone

(979) 431-4135

Specialties & licenses 3

Addresses

Other names 1

• Peach Creek Assisted Living Facility Doing business as

Electronic endpoints 1

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

{
    "created_epoch": "1668988800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1668988800000",
    "number": "1437868239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1488 STOKES CIR",
            "city": "COLLEGE STATION",
            "state": "TX",
            "postal_code": "778458772",
            "telephone_number": "979-431-4135",
            "fax_number": "855-662-8109"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1488 STOKES CIR",
            "city": "COLLEGE STATION",
            "state": "TX",
            "postal_code": "778458772",
            "telephone_number": "979-431-4135",
            "fax_number": "855-662-8109"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEACH CREEK ALF 1 LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-11-21",
        "last_updated": "2022-11-21",
        "certification_date": "2022-11-21",
        "status": "A",
        "authorized_official_last_name": "HARRIS",
        "authorized_official_first_name": "RACHEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "979-431-4135",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "BSN, RN"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "3104A0625X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility, Assisted Living, Mental Illness",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "385H00000X",
            "taxonomy_group": "",
            "desc": "Respite Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "peachcreek.rharris@gmail.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1488 Stokes Cir",
            "city": "College Station",
            "state": "TX",
            "country_code": "US",
            "postal_code": "778458772",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Peach Creek Assisted Living Facility",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kiersten Faith Pawlik, RBT
• Jamie Pawlowski, M.D.
• Mary Payne, LCSW
• PB Behavioral Brazos Valley, LLC
• PBH Professional Group, P.a.
• Roger Peart, PHARM.D.,R.PH
• Allison Faye Pedersen, MSN, APRN, FNP-BC
• Kevin Y Pei, M.D.
• Christopher Ronald Peoples, PHARM.D., RPH.
• Atalia Perez

• Assisted Living Facility in College Station, TX
• Providers in College Station, TX by specialty
• Assisted Living Facility in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2022; 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.