Provider Demographics
NPI:1578241394
Name:PEACEHOME MICHIGAN INC
Entity Type:Organization
Organization Name:PEACEHOME MICHIGAN INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:CASMIR
Authorized Official - Middle Name:
Authorized Official - Last Name:NNAJI
Authorized Official - Suffix:
Authorized Official - Credentials:PRESIDENT
Authorized Official - Phone:248-508-2662
Mailing Address - Street 1:28755 SAN CARLOS ST
Mailing Address - Street 2:
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48076-2378
Mailing Address - Country:US
Mailing Address - Phone:248-508-2662
Mailing Address - Fax:
Practice Address - Street 1:26732 FLORENCE ST
Practice Address - Street 2:
Practice Address - City:INKSTER
Practice Address - State:MI
Practice Address - Zip Code:48141-2506
Practice Address - Country:US
Practice Address - Phone:313-908-9433
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-11
Last Update Date:2023-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3104A0630XNursing & Custodial Care FacilitiesAssisted Living FacilityAssisted Living, Behavioral Disturbances