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General NPI Number Information
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NPI Number | 1639405657
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Entity Type | Organization
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Legal Business Name | PEACE HOME HEALTH SERVICES INC
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Dates
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Enumeration Date | 10/27/2009
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Last Update Date | 08/20/2015
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Provider Practice Location Address
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Address Line | 23800 W 10 MILE RD SUITE 110
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City | SOUTHFIELD
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State | MI
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Zip | 48033-3176
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Country | US
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Telephone | 248-208-8901
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Fax | 248-395-0226
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Provider Business Mailing Address
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Address Line | 23800 W 10 MILE RD SUITE 110
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City | SOUTHFIELD
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State | MI
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Zip | 48033-3176
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Country | US
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Telephone | 248-208-8901
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Fax | 248-395-0226
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | STEPHANIE D BOLTON
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Credential |
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Telephone | 248-208-8901
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State | MI
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