PEACEFUL HOUSE #3
Adult Care Home
Durham, North Carolina
Provider NPI: 1780882019
Organization Information:Organization Name: PEACEFUL HOUSE #3
Practice Location:
2724 MARLIN DR DURHAM, NC 27703 US
Tel: 919-596-4667 Fax: --
Business Mailing Address:
,
Tel: -- Fax: --
Taxonomy:
Other Provider Identifiers:
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin
Practice Location:
2724 MARLIN DR DURHAM, NC 27703 US
Tel: 919-596-4667 Fax: --
Business Mailing Address:
,
Tel: -- Fax: --
Taxonomy:
Primary | Code | Category/Description | State | License Number |
---|---|---|---|---|
Y | 311ZA0620X | Nursing & Custodial Care Facilities Custodial Care Facility Adult Care Home | NC | MHL-032-348 |
Other Provider Identifiers:
Issuer | Number | State | Type |
---|---|---|---|
7805386 | NC | 05 |
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin