Provider Demographics
NPI:1659860039
Name:PEACEFUL HOME CARE
Entity Type:Organization
Organization Name:PEACEFUL HOME CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:CASSANDRA
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:GANT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:866-415-0440
Mailing Address - Street 1:175 SW 7TH ST STE 1900
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33130-2960
Mailing Address - Country:US
Mailing Address - Phone:866-415-0440
Mailing Address - Fax:
Practice Address - Street 1:175 SW 7TH ST STE 1900
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33130-2960
Practice Address - Country:US
Practice Address - Phone:866-415-0440
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:JLC MANAGEMENT SOLUTIONS LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-05-01
Last Update Date:2018-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care