=====================================================
General NPI Number Information
=====================================================
NPI Number | 1285412874
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | P.E.A.C.E MENTAL HEALTH SERVICES
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/15/2023
-----------------------------------------------------
Last Update Date | 12/30/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 22063 CASCADE MOUNTAIN DR
-----------------------------------------------------
City | PORTER
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77365-7158
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 804-979-8611
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 22063 CASCADE MOUNTAIN DR
-----------------------------------------------------
City | PORTER
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77365-7158
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 804-979-8611
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER & OPERATOR
-----------------------------------------------------
Name | TIQUANA CHERIE HILL
-----------------------------------------------------
Credential | M.A., LPC
-----------------------------------------------------
Telephone | 804-979-8611
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251S00000X
-----------------------------------------------------
Taxonomy Name | Community/Behavioral Health Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 251B00000X
-----------------------------------------------------
Taxonomy Name | Case Management Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------