Provider Demographics
NPI:1194392357
Name:PEACEFUL PROMISE, INC
Entity Type:Organization
Organization Name:PEACEFUL PROMISE, INC
Other - Org Name:PEACEFUL PROMISE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:JASON
Authorized Official - Middle Name:
Authorized Official - Last Name:DESADIER
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:707-334-6089
Mailing Address - Street 1:1444 BELMONT PARK RD
Mailing Address - Street 2:
Mailing Address - City:OCEANSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92057-5727
Mailing Address - Country:US
Mailing Address - Phone:858-382-3328
Mailing Address - Fax:
Practice Address - Street 1:440 S. MELROSE DRIVE
Practice Address - Street 2:SUITE 205
Practice Address - City:VISTA
Practice Address - State:CA
Practice Address - Zip Code:92081-9208
Practice Address - Country:US
Practice Address - Phone:858-888-3811
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-07
Last Update Date:2023-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty