| NPI | 1730843814 |
|---|---|
| Former Legal Business Name | A PEACEFUL HOME OF LEWISTON |
| Entity Type | Organization |
| Authorized Contact | MICHAEL BERRY ST JUSTE President 941-536-6967 |
| Organization Subpart ? | No |
| Primary Taxonomy | 253Z00000X In Home Supportive Care |
| Enumeration Date | 2021-10-26 |
| Last Update Date | 2021-10-26 |