Healthcare Provider Details

I. General information

NPI: 1396410346
Provider Name (Legal Business Name): PERFECT PEACE PERSONNEL SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/11/2021
Last Update Date: 08/11/2021
Certification Date: 08/11/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

294 W MAIN ST STE 101
DOTHAN AL
36301-1658
US

IV. Provider business mailing address

PO BOX 1032
DALEVILLE AL
36322-1032
US

V. Phone/Fax

Practice location:
  • Phone: 334-447-1737
  • Fax:
Mailing address:
  • Phone: 334-447-1737
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251K00000X
TaxonomyPublic Health or Welfare Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State

VIII. Authorized Official

Name: TRAVERA ELIZABETH WALKER
Title or Position: REGISTERED NURSE
Credential:
Phone: 334-447-1737