Provider Demographics
NPI:1336586783
Name:PEACEFIELD HEALTH CARE, LLC.
Entity type:Organization
Organization Name:PEACEFIELD HEALTH CARE, LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:COSTIGAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:626-374-2264
Mailing Address - Street 1:780 LAKEFIELD RD STE D
Mailing Address - Street 2:
Mailing Address - City:WESTLAKE VILLAGE
Mailing Address - State:CA
Mailing Address - Zip Code:91361-2654
Mailing Address - Country:US
Mailing Address - Phone:626-374-2264
Mailing Address - Fax:626-256-9065
Practice Address - Street 1:780 LAKEFIELD RD STE D
Practice Address - Street 2:
Practice Address - City:WESTLAKE VILLAGE
Practice Address - State:CA
Practice Address - Zip Code:91361-2654
Practice Address - Country:US
Practice Address - Phone:626-374-2264
Practice Address - Fax:626-256-9065
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-24
Last Update Date:2013-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health