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General NPI Number Information
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NPI Number | 1073120242
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Entity Type | Organization
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Legal Business Name | PEACE IN LIFE, LLC.
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Dates
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Enumeration Date | 09/30/2020
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Last Update Date | 09/30/2020
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Provider Practice Location Address
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Address Line | 3101 AMERICAN LEGION ROAD 21A
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City | CHESAPEAKE
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State | VA
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Zip | 23321
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Country | US
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Telephone | 757-348-3168
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Fax |
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Provider Business Mailing Address
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Address Line | 3101 AMERICAN LEGION ROAD 21A
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City | CHESAPEAKE
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State | VA
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Zip | 23321
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Country | US
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Telephone | 757-348-3168
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | JEANETTE WHITEHEAD
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Credential |
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Telephone | 757-348-3168
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 311ZA0620X
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Taxonomy Name | Adult Care Home Facility
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License Number |
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License Number State |
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