Healthcare Provider Details

I. General information

NPI: 1285412874
Provider Name (Legal Business Name): P.E.A.C.E MENTAL HEALTH SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/15/2023
Last Update Date: 01/15/2026
Certification Date: 01/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22063 CASCADE MOUNTAIN DR
PORTER TX
77365-7158
US

IV. Provider business mailing address

22063 CASCADE MOUNTAIN DR
PORTER TX
77365-7158
US

V. Phone/Fax

Practice location:
  • Phone: 804-979-8611
  • Fax:
Mailing address:
  • Phone: 804-979-8611
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: TIQUANA CHERIE HILL
Title or Position: OWNER & OPERATOR
Credential: M.A., LPC
Phone: 804-979-8611