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General NPI Number Information
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NPI Number | 1306451117
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Entity Type | Organization
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Legal Business Name | PEACEFUL HOSPICE CARE AGENCY LLC
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Dates
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Enumeration Date | 09/09/2020
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Last Update Date | 12/08/2020
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Provider Practice Location Address
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Address Line | 8021 W TOWER AVE
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City | MILWAUKEE
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State | WI
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Zip | 53223-3215
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Country | US
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Telephone | 414-362-4227
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Fax |
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Provider Business Mailing Address
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Address Line | 8021 W TOWER AVE
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City | MILWAUKEE
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State | WI
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Zip | 53223-3215
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | MONA WILLIAMS
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Credential |
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Telephone | 414-362-4227
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RH0002X
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Taxonomy Name | Hospice and Palliative Medicine (Internal Medicine) Physician
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License Number |
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License Number State |
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