Healthcare Provider Details

I. General information

NPI: 1043126790
Provider Name (Legal Business Name): PEACE VALLEY RECOVERY II, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/21/2026
Last Update Date: 08/21/2026
Certification Date: 08/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3625 QUAKERBRIDGE RD STE B
HAMILTON NJ
08619-1268
US

IV. Provider business mailing address

3625 QUAKERBRIDGE RD STE B
HAMILTON NJ
08619-1268
US

V. Phone/Fax

Practice location:
  • Phone: 888-546-1770
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MICHAEL PARKER
Title or Position: CEO
Credential:
Phone: 215-780-1953