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Organization
PEACE HAVEN ASSISTED LIVING LLC
Active
Organization
PEACE HAVEN ASSISTED LIVING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY NEAL (OWNER/ADMINISTRATOR)
(336) 995-1418
Entity
Organization
Contact information
Practice address
178 S PEACE HAVEN RD, WINSTON SALEM, NC 27104-4439
(336) 995-1418
Mailing address
3825 TURNBERRY PARK DR, PFAFFTOWN, NC 27040-8625
(336) 995-1418
Taxonomy
Speciality
Code
Description
License number
State
251T00000X
PACE Provider Organization
—
NULL
310400000X
Assisted Living Facility
—
NULL
311Z00000X
Custodial Care Facility
—
NULL
311ZA0620X
Adult Care Home Facility
Primary
—
NULL
Other
Enumeration date
12/29/2021
Last updated
12/29/2021
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