Provider Demographics
NPI:1679021992
Name:PEACEFUL TRANQUILITY ADULT CARE SERVICES
Entity Type:Organization
Organization Name:PEACEFUL TRANQUILITY ADULT CARE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JEAN
Authorized Official - Middle Name:
Authorized Official - Last Name:BELLOT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-470-6760
Mailing Address - Street 1:113 SHREVEPORT RD
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23223-3394
Mailing Address - Country:US
Mailing Address - Phone:954-470-6760
Mailing Address - Fax:
Practice Address - Street 1:113 SHREVEPORT RD
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23223-3394
Practice Address - Country:US
Practice Address - Phone:954-470-6760
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-15
Last Update Date:2016-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
No311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home