Provider Demographics
NPI:1043755978
Name:PEACEFUL LIVING HOME CARE, LLC
Entity Type:Organization
Organization Name:PEACEFUL LIVING HOME CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:I
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:855-658-1670
Mailing Address - Street 1:PO BOX 616
Mailing Address - Street 2:
Mailing Address - City:ROLESVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27571-0616
Mailing Address - Country:US
Mailing Address - Phone:855-658-1670
Mailing Address - Fax:855-658-1674
Practice Address - Street 1:610 UPWEY CT
Practice Address - Street 2:
Practice Address - City:ROLESVILLE
Practice Address - State:NC
Practice Address - Zip Code:27571-9218
Practice Address - Country:US
Practice Address - Phone:855-658-1670
Practice Address - Fax:855-658-1674
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-02
Last Update Date:2017-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCHC4854385HR2050X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385HR2050XRespite Care FacilityRespite CareRespite Care Camp