Peaceful Home Alf LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

PEACEFUL HOME ALF LLC

Practice address

66 Patric Dr
Palm Coast, FL 32164-7588

Phone

(386) 597-7750

NPI assigned

May 20, 2024

Organization subpart

No

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

Authorized official

Name

Mary Rivera

Title

Owner

Phone

(386) 986-6557

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1716163200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1716163200000",
    "number": "1851130918",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "66 PATRIC DR",
            "city": "PALM COAST",
            "state": "FL",
            "postal_code": "321647588",
            "telephone_number": "386-597-7750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "66 PATRIC DR",
            "city": "PALM COAST",
            "state": "FL",
            "postal_code": "321647588",
            "telephone_number": "386-597-7750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEACEFUL HOME ALF LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-05-20",
        "last_updated": "2024-05-20",
        "certification_date": "2024-05-20",
        "status": "A",
        "authorized_official_last_name": "RIVERA",
        "authorized_official_first_name": "MARY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "386-986-6557"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Assisted Living Facility in Palm Coast, FL
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 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.