Healthcare Provider Details

I. General information

NPI: 1194424366
Provider Name (Legal Business Name): PEACE WITHIN MY HEART HOME HEALTH CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/27/2023
Last Update Date: 02/27/2023
Certification Date: 02/23/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1170 SUTTON BRIGDE RD
RAINBOW CITY AL
35906-6011
US

IV. Provider business mailing address

1170 SUTTON BRIGDE RD
RAINBOW CITY AL
35906
US

V. Phone/Fax

Practice location:
  • Phone: 800-950-5375
  • Fax:
Mailing address:
  • Phone: 800-950-5375
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: JONI JONES
Title or Position: OWNER
Credential:
Phone: 404-216-3672