PEACE VILLA INC. NPI 1851842611

NPI Information

NPI: 1851842611
Provider Name: PEACE VILLA INC.

Doing Business As: THE HAVEN AT PEACE VILLAGE

Classification: Assisted Living Facility - 310400000X
Entity Type: Organization

Address:
600 RAILROAD DR
NORWOOD YOUNG AMERICA, MN
ZIP 55368
Phone: (952) 467-3692
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PEACE VILLA INC. is an assisted living facility in Norwood Young America, MN. The provider is a facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being. PEACE VILLA INC. NPI is 1851842611. The provider is registered as an organization entity type.
The provider Is Doing Business As The Haven At Peace Village.

The provider's business location address is:

600 RAILROAD DR
NORWOOD YOUNG AMERICA, MN
ZIP 55368-601
Phone: (952) 467-3692
Fax: (952) 467-3156

The provider's authorized official is Laurie Hilgers .
The authorized official title is Housing Director and has the following contact phone number (952) 467-9683.

The CLIA number assigned to this NPI record is 24D2104918 - assisted living facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 10/17/2016 and was last updated on 10/17/2016.

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	311500000X	Alzheimer Center (Dementia Center)		378632	MINNESOTA	No
2	310400000X	Assisted Living Facility		378221	MINNESOTA	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	A080412300	OTHER	MINNESOTA	MHCP - MINNESOTA DEPT. OF HUMAN SERVICES

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: 4/28/2024

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