Organization · NPI-2
Peachy Orchard LLC
In Home Supportive Care · Crestview, FL
NPI number1083598676
StatusActive
Last updated in NPPESAug 5, 2025
Details
- NPI
- 1083598676
- Entity type
- Organization (NPI-2)
- Legal business name
- Peachy Orchard LLC
- Organization subpart
- No
- Enumeration date
- Aug 5, 2025
- Certification date
- Jul 30, 2025
- Last updated
- Aug 5, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 253Z00000X | In Home Supportive Care | – | – | Yes |
| 251S00000X | Community/Behavioral Health | – | – | |
| 251E00000X | Home Health | – | – | |
| 251B00000X | Case Management | – | – | |
| 251C00000X | Day Training, Developmentally Disabled Services | – | – |
Practice location
412 Juniper DrCrestview, FL 32536-9223
Phone 334-939-2170
Mailing address
3313 Falco RdWing, AL 36483-7101
Phone 334-939-2170
Authorized official
Eratina E Opel
Owner
3349392170
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