Provider Demographics
NPI:1457790420
Name:PEACEFUL LIFE ASSISTED LIVING
Entity Type:Organization
Organization Name:PEACEFUL LIFE ASSISTED LIVING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ALM
Authorized Official - Prefix:
Authorized Official - First Name:CHARITY
Authorized Official - Middle Name:
Authorized Official - Last Name:BARRETT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:240-493-6441
Mailing Address - Street 1:7708 OLD ALEXANDRIA FERRY RD
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:MD
Mailing Address - Zip Code:20735-1872
Mailing Address - Country:US
Mailing Address - Phone:301-856-8015
Mailing Address - Fax:888-557-2119
Practice Address - Street 1:7029 GROVETON DR
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:MD
Practice Address - Zip Code:20735-4046
Practice Address - Country:US
Practice Address - Phone:301-868-6198
Practice Address - Fax:301-868-7956
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-22
Last Update Date:2013-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility