Provider Demographics
NPI:1760062954
Name:PEACE LIVING LLC
Entity Type:Organization
Organization Name:PEACE LIVING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:SALEM
Authorized Official - Middle Name:
Authorized Official - Last Name:BEYENE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:602-793-3603
Mailing Address - Street 1:3712 W LEODRA LN
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85041-5288
Mailing Address - Country:US
Mailing Address - Phone:602-793-3603
Mailing Address - Fax:
Practice Address - Street 1:3712 W LEODRA LN
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85041-5288
Practice Address - Country:US
Practice Address - Phone:602-793-3603
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-12
Last Update Date:2021-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Single Specialty