NPIMap

Organization Active NPI

Peaceful House #3

  • Adult Care Home Facility
  • Durham, NC
National Provider Identifier
1780882019
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Care Home FacilityTaxonomy code 311ZA0620X
License
MHL-032-348 Issued in NC
Legal business name
PEACEFUL HOUSE #3
Practice address
2724 Marlin Dr
Durham, NC 27703-4354
Phone
(919) 596-4667
NPI assigned
Jul 9, 2007
Last updated
Jul 9, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Authorized official

Name
Mrs. Tammy Hatley
Title
Owner
Phone
(919) 641-7981

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Care Home Facility 311ZA0620X MHL-032-348 NC Primary

Addresses

Primary practice location

2724 Marlin Dr
Durham, NC 27703-4354

Mailing address

2724 Marlin Dr
Durham, NC 27703-4354
Phone (919) 596-4667

Other identifiers 1

IdentifierTypeStateIssuer
7805386MedicaidNC

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1183939200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1183939200000",
    "number": "1780882019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2724 MARLIN DR",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277034354",
            "telephone_number": "919-596-4667"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2724 MARLIN DR",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277034354",
            "telephone_number": "919-596-4667"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEACEFUL HOUSE #3",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-09",
        "last_updated": "2007-07-09",
        "status": "A",
        "authorized_official_last_name": "HATLEY",
        "authorized_official_first_name": "TAMMY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "919-641-7981",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": "NC",
            "license": "MHL-032-348",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7805386",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Durham, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.