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Organization
PEACEFUL CARE HOUSE
Active
Organization
PEACEFUL CARE HOUSE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS ESTERA BODALE (CARE PROVIDER)
(503) 760-4262
Entity
Organization
Contact information
Practice address
10254 SE ISAAC DR, HAPPY VALLEY, OR 97086-7159
(503) 760-4262
(503) 762-2186
Mailing address
10254 SE ISAAC DR, HAPPY VALLEY, OR 97086-7159
(503) 760-4262
(503) 762-2186
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
0312-513850-0803-P
OR
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
03125138500803P
OR
Other
Enumeration date
08/06/2009
Last updated
08/06/2009
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