PEACEFUL HOME ASSISTED LIVING, INC (NPI# 1396200416) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1396200416 |
| Entity Type | Organization |
| Organization Name | PEACEFUL HOME ASSISTED LIVING, INC |
| Practice Address |
1186 Saint Paul Ave Saint Paul MN 55116-2557 |
| Mailing Address |
1731 Selby Ave Saint Paul MN 55104-6154 |
| Practice Telephone | 6122035035 |
| Practice Fax Number | 6516447041 |
| Mailing Telephone | 6122035035 |
| Mailing Fax Number | 6516447041 |
| Enumeration Date | 2019-02-02 |
| Last Update Date | 2019-02-02 |
| Authorized Official Name | MR. YASSIN A IBRAHIM (PRESIDENT) |
| Authorized Official Telephone | 6122035035 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3104A0630X |
Assisted Living Facility Specialization: Assisted Living, Behavioral Disturbances |
Nursing & Custodial Care Facilities |
| Street Address |
1186 SAINT PAUL AVE |
| City | SAINT PAUL |
| State | MN |
| Zip Code | 55116-2557 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568017374 | The Bridge Autism Clinic LLC | Clinic/Center | 690 Cleveland Ave South, Suite 100, St Paul, MN 55116 | 2019-08-08 |
| 1205306875 | Center for Validation and Change, L.L.C. | Social Worker | 790 Cleveland Avenue S. Ste; 211 790, St. Paul, MN 55116 | 2018-11-27 |
| 1114391307 | Therese Ann Wengler | Rehabilitation Hospital | 1206 Niles Avenue, Saint Paul, MN 55116 | 2015-11-25 |
| 1306220579 | Lauren Ann Wier | Social Worker | 577 Wawick St, Saint Paul, MN 55116 | 2015-07-16 |
| 1982097325 | Norah Hoverson | Dentist | 670 Cleveland Ave S Ste 100, Saint Paul, MN 55116 | 2015-03-10 |
| 1316336803 | Ryan W. Nolte | Chiropractor | 1150 Montreal Ave Ste 101, Saint Paul, MN 55116 | 2015-01-21 |
| 1316348642 | Highland Gw, LLC | Assisted Living Facility | 1925 Graham Avenue, St. Paul, MN 55116 | 2014-09-05 |
| 1972941185 | Creations Midwifery, LLC | Advanced Practice Midwife | 1235 Saint Paul Avenue, Saint Paul, MN 55116 | 2013-06-10 |
| 1992075428 | Nels Health Care, LLC | Licensed Practical Nurse | 2285 Stewart Ave, Suite 1107, St Paul, MN 55116 | 2011-12-30 |
| 1962717728 | Lindsey Hammond Teigland | Psychologist | 690 Cleveland Avenue South, St. Paul, MN 55116 | 2010-08-17 |
| Find all providers in zip 55116 | ||||
| Taxonomy Code | 3104A0630X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Assisted Living Facility |
| Specialization | Assisted Living, Behavioral Disturbances |
| A facility providing supportive services to individuals who can function independently in most areas of activity, but exhibit abnormal behavioral responses and habits and therefore need special guidance, assistance and/or monitoring to assure safety and well being. This type of facility requires a staff with special training in dealing with and redirecting negative, violent or destructive behaviors. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922581685 | Sunlight Services LLC | Assisted Living Facility | 440 Virginia St, Saint Paul, MN 55103-2353 | 2018-09-10 |
| 1134487556 | Summit Senior Living, LLC | Assisted Living Facility | 1870 Old Hudson Rd, Saint Paul, MN 55119-4307 | 2012-04-24 |
| 1326312588 | Investing In Behavioral Services International | Assisted Living Facility | 199 Cesar Chavez St, Saint Paul, MN 55107-2309 | 2012-03-05 |
| 1932419504 | Asian American Elderly Assisted Living | Assisted Living Facility | 2113 Minnehaha Ave E, Saint Paul, MN 55119-3931 | 2010-10-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609499664 | Vaimar Suites LLC | Assisted Living Facility | 7900 Douglas Dr N, Brooklyn Park, MN 55443-2046 | 2020-05-26 |
| 1033415070 | Arbor Lakes Senior Living | Assisted Living Facility | 12001 80th Avenue North, Maple Grove, MN 55369 | 2011-02-09 |
| 1083847610 | Inverwood Senior Living LLC | Assisted Living Facility | 7260 So. Robert Trail, Inver Grove Heights, MN 55077 | 2009-08-31 |
| 1073669859 | Tender Loving Care of Duluth, Inc. | Assisted Living Facility | 2715 Piedmont Ave, Duluth, MN 55811-2935 | 2007-01-26 |
| 1922628874 | Redesign Lifestyle Care LLC | Assisted Living Facility | 1527 Morgan Ave N, Minneapolis, MN 55411-3013 | 2020-04-21 |
| 1730466533 | Dependable Home Healthcare, Inc | Assisted Living Facility | 2984 Rice St, Little Canada, MN 55113-2230 | 2011-11-08 |
| City | SAINT PAUL |
| Zip Code | 55116 |
Please comment or provide details below to improve the information on PEACEFUL HOME ASSISTED LIVING, INC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.