Healthcare Provider Details

I. General information

NPI: 1417852773
Provider Name (Legal Business Name): PEACE PSYCHIATRY & EMOTIONAL WELLNESS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/08/2026
Last Update Date: 10/08/2026
Certification Date: 10/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2005 BLAINE ST
CALDWELL ID
83605-4344
US

IV. Provider business mailing address

2005 BLAINE ST
CALDWELL ID
83605-4344
US

V. Phone/Fax

Practice location:
  • Phone: 208-453-6986
  • Fax:
Mailing address:
  • Phone: 208-453-6986
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number StateNULL

VIII. Authorized Official

Name: BENJAMIN CALL
Title or Position: PROVIDER/OWNER
Credential: APRN
Phone: 253-205-9840