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General NPI Number Information
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NPI Number | 1043985799
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Entity Type | Organization
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Legal Business Name | CITY OF PEACE HEALTH CARE SERVICES LLC
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Dates
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Enumeration Date | 08/14/2021
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Last Update Date | 04/09/2025
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Provider Practice Location Address
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Address Line | 8727 GREENBELT RD STE 201
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City | GREENBELT
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State | MD
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Zip | 20770-2491
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Country | US
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Telephone | 202-560-4899
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Fax |
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Provider Business Mailing Address
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Address Line | 2423 NICOL CIR
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City | MITCHELLVILLE
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State | MD
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Zip | 20721-2907
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Country | US
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Telephone | 202-560-4899
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Fax |
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Authorized Official
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Title or Position | PRESIDENT/CEO
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Name | JOSEPHINE IBEH
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Credential | BSN
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Telephone | 202-560-4899
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251J00000X
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Taxonomy Name | Nursing Care Agency
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 343900000X
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Taxonomy Name | Non-emergency Medical Transport (VAN)
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 320600000X
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Taxonomy Name | Intellectual and/or Developmental Disabilities Residential Treatment Facility
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License Number |
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License Number State |
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