# PEACEFUL HAVEN RANCH GROUP HOME

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

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

## Provider details

- **NPI number:** 1982881702
- **Authorized official:** MR. ALBERTO E FERNANDEZ (PRESIDENT)
- **Authorized official phone:** (954) 689-0151

## Contact information

- **Practice address:** 12601 STIRLING RD, SOUTHWEST RANCHES, FL 33330-3215
- **Practice address phone:** (954) 689-0151
- **Practice address fax:** (954) 680-9474
- **Mailing address:** 12601 STIRLING RD, SOUTHWEST RANCHES, FL 33330-3215
- **Mailing address phone:** (954) 689-0151
- **Mailing address fax:** (954) 680-9474

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 320600000X | Intellectual and/or Developmental Disabilities Residential Treatment Facility | 10-1606GH | FL | Yes |
| 320600000X | Intellectual and/or Developmental Disabilities Residential Treatment Facility | 10-1607GH | FL | — |

## Other

- **Enumeration date:** 01/23/2008
- **Last updated:** 01/23/2008