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General NPI Number Information
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NPI Number | 1154268100
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Entity Type | Organization
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Legal Business Name | PEACHES AND CREAM FOUNDATION
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Dates
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Enumeration Date | 04/29/2026
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Last Update Date | 04/29/2026
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Provider Practice Location Address
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Address Line | 6724 GA HIGHWAY 88 E
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City | KEYSVILLE
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State | GA
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Zip | 30816-4186
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Country | US
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Telephone | 215-971-7266
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Fax |
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Provider Business Mailing Address
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Address Line | 6724 GA HIGHWAY 88 E
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City | KEYSVILLE
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State | GA
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Zip | 30816-4186
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Country | US
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Telephone | 215-971-7266
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Fax |
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Authorized Official
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Title or Position | CHAIRWOMAN
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Name | LATESHIA BUTCHER
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Credential |
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Telephone | 267-888-5099
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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