Healthcare Provider Details

I. General information

NPI: 1124134259
Provider Name (Legal Business Name): PEACE HOME HEALTH INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/22/2006
Last Update Date: 06/23/2024
Certification Date: 06/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1401 N CENTRAL EXPY STE 385
RICHARDSON TX
75080-4681
US

IV. Provider business mailing address

1401 N CENTRAL EXPY STE 385
RICHARDSON TX
75080-4681
US

V. Phone/Fax

Practice location:
  • Phone: 972-744-0133
  • Fax:
Mailing address:
  • Phone: 972-744-0133
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number009229
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code372600000X
TaxonomyAdult Companion
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number State

VIII. Authorized Official

Name: JANE UWAGA
Title or Position: ADMINISTRATOR
Credential:
Phone: 972-744-0133