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General NPI Number Information
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NPI Number | 1043015688
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Entity Type | Organization
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Legal Business Name | PEACE HEALTHCARE INC
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Dates
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Enumeration Date | 02/18/2025
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Last Update Date | 02/18/2025
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Provider Practice Location Address
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Address Line | 6806 HOLABIRD AVE
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City | DUNDALK
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State | MD
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Zip | 21222-1784
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Country | US
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Telephone | 410-237-7188
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Fax | 410-304-6780
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Provider Business Mailing Address
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Address Line | 6806 HOLABIRD AVE
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City | DUNDALK
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State | MD
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Zip | 21222-1784
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Country | US
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Telephone | 410-237-7188
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Fax | 410-304-6780
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Authorized Official
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Title or Position | CEO
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Name | PRISCILLA BENEWAAH
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Credential |
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Telephone | 410-499-4707
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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