Provider Demographics
NPI:1174376180
Name:PEACEFUL BEGINNINGS ASSISTED LIVING FACILITY LLC
Entity type:Organization
Organization Name:PEACEFUL BEGINNINGS ASSISTED LIVING FACILITY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:OTSHEEL
Authorized Official - Middle Name:
Authorized Official - Last Name:RENE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-297-0107
Mailing Address - Street 1:3570 HARLOWE AVE
Mailing Address - Street 2:
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33436-3111
Mailing Address - Country:US
Mailing Address - Phone:561-200-9138
Mailing Address - Fax:
Practice Address - Street 1:3570 HARLOWE AVE
Practice Address - Street 2:
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33436-3111
Practice Address - Country:US
Practice Address - Phone:561-200-9138
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-09
Last Update Date:2024-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility