Healthcare Provider Details

I. General information

NPI: 1043012743
Provider Name (Legal Business Name): A PEACEFUL PLACE INTEGRATED CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/25/2025
Last Update Date: 03/25/2025
Certification Date: 03/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1001 S BRADFORD ST STE 7
DOVER DE
19904-4153
US

IV. Provider business mailing address

1001 S BRADFORD ST STE 7
DOVER DE
19904-4153
US

V. Phone/Fax

Practice location:
  • Phone: 302-264-9436
  • Fax: 302-264-9702
Mailing address:
  • Phone: 302-264-9436
  • Fax: 302-264-9702

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: ERICKA TAYLOR-DANIEL
Title or Position: OWNER
Credential: APRN
Phone: 302-264-9436