Healthcare Provider Details

I. General information

NPI: 1386424158
Provider Name (Legal Business Name): ECUMENISM FOR PEACE INTEGRATED HEALTHCARE & SOCIAL SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/29/2023
Last Update Date: 09/29/2023
Certification Date: 09/29/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9800 W PEORIA AVE STE 2
PEORIA AZ
85345-6148
US

IV. Provider business mailing address

10332 W ROBIN LN
PEORIA AZ
85383-2690
US

V. Phone/Fax

Practice location:
  • Phone: 623-707-6554
  • Fax:
Mailing address:
  • Phone: 602-538-2543
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License Number
License Number State

VIII. Authorized Official

Name: MR. SAMUEL IGWE AGUBE
Title or Position: CHIEF EXECUTIVE OFFICER/ADM.
Credential: MBA, LPN, B.ENG. CQC
Phone: 623-707-6554