Healthcare Provider Details

I. General information

NPI: 1801725882
Provider Name (Legal Business Name): SPACE OF PEACE HOME HEALTH CARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/15/2026
Last Update Date: 05/15/2026
Certification Date: 05/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1909 TREETOP LN APT 13
SILVER SPRING MD
20904-6621
US

IV. Provider business mailing address

1909 TREETOP LN APT 13
SILVER SPRING MD
20904-6621
US

V. Phone/Fax

Practice location:
  • Phone: 301-513-4067
  • Fax:
Mailing address:
  • Phone: 301-513-4067
  • Fax:

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: MS. ENGONWIE DORIS NDAM
Title or Position: OWNER AND REGISTERED NURSE
Credential: REGISTERED NURSE
Phone: 240-467-6756