Provider Demographics
NPI:1104036045
Name:PEACEFUL LIVING ENTERPRISES, INC.
Entity Type:Organization
Organization Name:PEACEFUL LIVING ENTERPRISES, INC.
Other - Org Name:COMFORT KEEPERS #511
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JANET
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:VANOSTENBRIDGE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:719-522-9100
Mailing Address - Street 1:5245 CENTENNIAL BLVD STE 202
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80919-4405
Mailing Address - Country:US
Mailing Address - Phone:719-522-9100
Mailing Address - Fax:719-520-0590
Practice Address - Street 1:5245 CENTENNIAL BLVD STE 202
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80919-4405
Practice Address - Country:US
Practice Address - Phone:719-522-9100
Practice Address - Fax:719-520-0590
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health