# PEACE HAVEN ASSISTED LIVING LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1316607534
- **Authorized official:** KIMBERLY NEAL (OWNER/ADMINISTRATOR)
- **Authorized official phone:** (336) 995-1418

## Contact information

- **Practice address:** 178 S PEACE HAVEN RD, WINSTON SALEM, NC 27104-4439
- **Practice address phone:** (336) 995-1418
- **Mailing address:** 3825 TURNBERRY PARK DR, PFAFFTOWN, NC 27040-8625
- **Mailing address phone:** (336) 995-1418

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251T00000X | PACE Provider Organization | — | NULL | — |
| 310400000X | Assisted Living Facility | — | NULL | — |
| 311Z00000X | Custodial Care Facility | — | NULL | — |
| 311ZA0620X | Adult Care Home Facility | — | NULL | Yes |

## Other

- **Enumeration date:** 12/29/2021
- **Last updated:** 12/29/2021