Provider Demographics
NPI:1275654592
Name:PEACEFUL HOUSE I, II & III
Entity Type:Organization
Organization Name:PEACEFUL HOUSE I, II & III
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:OGBONNAYA
Authorized Official - Last Name:ANYANSO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-403-0262
Mailing Address - Street 1:2801 SHOREHAM ST
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27707-3912
Mailing Address - Country:US
Mailing Address - Phone:919-403-0262
Mailing Address - Fax:919-790-1963
Practice Address - Street 1:2801 SHOREHAM ST
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27707-3912
Practice Address - Country:US
Practice Address - Phone:919-403-0262
Practice Address - Fax:919-790-1963
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCMHL032334251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health