A Peaceful Home Of Lewiston
In Home Supportive Care in Port Charlotte, FL. Organization (NPI-2).
NPI number1730843814
StatusActive
Last updated in NPPESOct 26, 2021
Details
- NPI
- 1730843814
- Entity type
- Organization (NPI-2)
- Legal business name
- A Peaceful Home Of Lewiston
- Organization subpart
- No
- Enumeration date
- Oct 26, 2021
- Certification date
- Oct 26, 2021
- Last updated
- Oct 26, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 253Z00000X | In Home Supportive Care | – | – | Yes |
Other names
- A Peaceful Home Of Lewiston (Former Legal Business Name)
Practice location
22456 Lewiston AvePort Charlotte, FL 33952-7172
Phone 941-536-6967 · Fax 941-460-4387
Mailing address
2908 102nd Ave EParrish, FL 34219-9203
Phone 941-536-6967
Authorized official
Michael Berry St Juste
President
9415366967
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