Provider Demographics
NPI:1669693701
Name:LIVING PEACEFUL, INC
Entity type:Organization
Organization Name:LIVING PEACEFUL, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:TINA
Authorized Official - Middle Name:RENE
Authorized Official - Last Name:PERKINS
Authorized Official - Suffix:
Authorized Official - Credentials:COO
Authorized Official - Phone:214-358-6815
Mailing Address - Street 1:3368 LOCKMOOR LN
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75220-1634
Mailing Address - Country:US
Mailing Address - Phone:214-358-6815
Mailing Address - Fax:
Practice Address - Street 1:3368 LOCKMOOR LN
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75220-1634
Practice Address - Country:US
Practice Address - Phone:214-358-6815
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-02
Last Update Date:2007-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility