Provider Demographics
NPI:1689356990
Name:HARVEST OF PEACE, LLC
Entity Type:Organization
Organization Name:HARVEST OF PEACE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:THERESE
Authorized Official - Middle Name:
Authorized Official - Last Name:LIVELLA
Authorized Official - Suffix:
Authorized Official - Credentials:LMT
Authorized Official - Phone:913-961-1481
Mailing Address - Street 1:421 NE JOHN STORM AVE UNIT 707
Mailing Address - Street 2:
Mailing Address - City:LA CENTER
Mailing Address - State:WA
Mailing Address - Zip Code:98629-0839
Mailing Address - Country:US
Mailing Address - Phone:913-961-1481
Mailing Address - Fax:
Practice Address - Street 1:305 W 5TH ST
Practice Address - Street 2:
Practice Address - City:LA CENTER
Practice Address - State:WA
Practice Address - Zip Code:98629-5448
Practice Address - Country:US
Practice Address - Phone:913-961-1481
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-04
Last Update Date:2023-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty