PEACEFUL CARE HOUSE NPI 1033340096

NPI Information

NPI: 1033340096
Provider Name: PEACEFUL CARE HOUSE
Classification: Residential Treatment Facility, Intellectual and/or Developmental Disabilities - 320600000X
Entity Type: Organization
Address: 10254 SE ISAAC DR
HAPPY VALLEY, OR
ZIP 97086
Phone: (503) 760-4262

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NPI Details

PEACEFUL CARE HOUSE is a residential treatment facility, intellectual and/or developmental disabilities in Happy Valley, OR. The provider is a residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with developmental and intellectual disabilities and are not able to live independently. PEACEFUL CARE HOUSE NPI is 1033340096. The provider is registered as an organization entity type.

The provider's business location address is:

10254 SE ISAAC DR
HAPPY VALLEY, OR
ZIP 97086-159
Phone: (503) 760-4262
Fax: (503) 762-2186

The provider's authorized official is Estera Bodale .
The authorized official title is Care Provider and has the following contact phone number (503) 760-4262.

The enumeration date for this NPI number is 8/6/2009 and was last updated on 8/6/2009.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	320900000X	Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities		03125138500803P	OREGON	No
2	320600000X	Residential Treatment Facility, Intellectual and/or Developmental Disabilities		0312-513850-0803-P	OREGON	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	513850	MEDICAID	OREGON

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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