# PEACEFUL HOUSE III

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

## Provider details

- **NPI number:** 1356546113
- **Authorized official:** CARLEY Y JEGBADAI RN (ADMINISTRATOR)
- **Authorized official phone:** (919) 790-1953

## Contact information

- **Practice address:** 2724 MARLIN DR, DURHAM, NC 27703-4354
- **Practice address phone:** (919) 641-7981
- **Practice address fax:** (919) 957-4681
- **Mailing address:** 2724 MARLIN DR, DURHAM, NC 27703-4354
- **Mailing address phone:** (919) 641-7981
- **Mailing address fax:** (919) 957-4681

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 311ZA0620X | Adult Care Home Facility | — | NULL | Yes |

## Other

- **Enumeration date:** 06/20/2007
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 7805386 | — | NC |