PEACEFUL RIVER RESIDENTIAL SERVICES (NPI# 1093175283) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1093175283 |
| Entity Type | Organization |
| Organization Name | PEACEFUL RIVER RESIDENTIAL SERVICES |
| Practice Address |
746 Rudgate Rd Columbus GA 31904-2929 |
| Practice Telephone | 7065718859 |
| Practice Fax Number | 7062436357 |
| Mailing Telephone | 7065718859 |
| Mailing Fax Number | 7062436357 |
| Enumeration Date | 2016-03-01 |
| Last Update Date | 2016-03-01 |
| Authorized Official Name | PAMELA S WILLIAMS (OWNER) |
| Authorized Official Telephone | 7066814211 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 320600000X | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | CLA001207 | GA | Residential Treatment Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 003136088A | 05 |
| Street Address |
746 RUDGATE RD |
| City | COLUMBUS |
| State | GA |
| Zip Code | 31904-2929 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821641457 | At Home Palliative Care, LLC | Nursing Care | 114 Enterprise Ct, Suite B, Columbus, GA 31904 | 2019-07-23 |
| 1285191049 | Shandra Ladell Grimes | Nurse Practitioner | 2300 Manchester Expwy St Francis Hospital, Suite C-001, Columbus, GA 31904 | 2019-02-27 |
| 1881161529 | Lesley Kathleen Simmons | Massage Therapist | 5402 15th Ave, Columbus, GA 31904 | 2018-10-31 |
| 1184190662 | Alphonsa Joseph | Nurse Practitioner | 2430 Brookstone Centre Parkway, Columbus, Georgia 31904, Columbus, GA 31904 | 2018-10-22 |
| 1568942704 | William Pearce Massey | Social Worker | 8851-1 Moore Road, Columbus, GA 31904 | 2018-08-17 |
| 1033696372 | Marlise V. Gray | Counselor | 2013 Devonshire Dr. Suite 115, Columbus, GA 31904 | 2018-07-19 |
| 1710418173 | Amanda Barnette Pruett | Behavioral Analyst | 200 Brookstone Centre Pkwy Bldg 200, Columbus, GA 31904 | 2017-03-27 |
| 1750833232 | Carrie Leigh Whitehead | Nurse Practitioner | 6228 Bradley Park Dr. Suite A, Columbus, GA 31904 | 2016-10-31 |
| 1609323369 | Shomika Lasha Battle | Registered Nurse | 2101 North Avenue, Columbus, GA 31904 | 2016-09-09 |
| 1952759219 | Peaceful River Home Care Agency | In Home Supportive Care | 738 Rudgate Road, Columbus, GA 31904 | 2016-05-27 |
| Find all providers in zip 31904 | ||||
| Taxonomy Code | 320600000X |
| Grouping | Residential Treatment Facilities |
| Classification | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities |
| A residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with developmental disabilities and/or mental retardation and are not able to live independently. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467067124 | Forever Care LLC | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 5240 Northtowne Blvd Apt C, Columbus, OH 43229-4661 | 2020-09-10 |
| 1740653260 | Nina Bell Homes LLC | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 3391 Penfield Rd, Columbus, OH 43227-3747 | 2015-11-05 |
| 1457736290 | Holly Hills Group Home | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 84 Gary Dr, Suite 102, Columbus, NC 28722-6437 | 2015-07-22 |
| 1558766170 | New Horizon Behavioral Health | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 9021 Veterans Parkway, Columbus, GA 31909 | 2014-10-24 |
| 1710387238 | Oasis Personal Care Services | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 945 Chesapeake Way, Columbus, GA 31907-7340 | 2014-09-03 |
| 1669800785 | Peris Gitahi | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 3380 Bruceton Ave, 3380 Bruceton Avenue, Columbus, OH 43232-4059 | 2013-10-29 |
| 1073851036 | Skiy Mitchell | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 723 Black Oak Dr, Columbus, GA 31907-5353 | 2013-01-26 |
| 1033492970 | America's Medical Dream Homes | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1336 E Main St Ste 203, Columbus, OH 43205-2081 | 2011-09-27 |
| 1194921288 | Care Focus, Inc. | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 200 E Campus View Blvd Ste 160, Columbus, OH 43235-4678 | 2007-06-25 |
| 1407905375 | Columbus Center for Human Services Inc | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 540 Industrial Mile Rd, Columbus, OH 43228-2413 | 2007-01-09 |
| Find all providers in COLUMBUS | ||||
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| 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.