Healthcare Provider Details

I. General information

NPI: 1619890563
Provider Name (Legal Business Name): AT PEACE HOME COMPANION SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/30/2026
Last Update Date: 07/30/2026
Certification Date: 07/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1548 TRUSCOTT CT
MOUNT DORA FL
32757-8807
US

IV. Provider business mailing address

1548 TRUSCOTT CT
MOUNT DORA FL
32757-8807
US

V. Phone/Fax

Practice location:
  • Phone: 352-356-8758
  • Fax: 561-202-3587
Mailing address:
  • Phone: 352-356-8758
  • Fax: 561-202-3587

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: MR. HENRY CLAUDE VICTOR
Title or Position: OWNER
Credential:
Phone: 407-963-6486