Organization
PEACEFUL HOME ASSISTED LIVING, INC
Active
Organization
PEACEFUL HOME ASSISTED LIVING, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. YASSIN A IBRAHIM (PRESIDENT)
(612) 203-5035
Entity
Organization
Contact information
Practice address
1186 SAINT PAUL AVE, SAINT PAUL, MN 55116-2557
(612) 203-5035
(651) 644-7041
Mailing address
1731 SELBY AVE, SAINT PAUL, MN 55104-6154
(612) 203-5035
(651) 644-7041
Taxonomy
Speciality
Code
Description
License number
State
3104A0630X
Assisted Living Facility (Behavioral Disturbances)
Primary
—
—
Other
Enumeration date
02/02/2019
Last updated
02/02/2019
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