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General NPI Number Information
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NPI Number | 1912698416
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Entity Type | Organization
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Legal Business Name | A PLACE OF PEACE PERSONAL CARE LLC
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Dates
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Enumeration Date | 05/16/2023
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Last Update Date | 05/16/2023
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Provider Practice Location Address
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Address Line | 1082 BOCA RATON DR
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City | FOREST PARK
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State | GA
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Zip | 30297-3445
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Country | US
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Telephone | 678-600-3298
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Fax |
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Provider Business Mailing Address
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Address Line | 1700 NORTHSIDE DRIVE STE. A7 PMB 3200
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City | ATLANTA
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State | GA
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Zip | 30318
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Country | US
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Telephone | 678-600-3298
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MS. SHARON WEATHERSPOON
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Credential |
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Telephone | 678-964-9199
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 376K00000X
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Taxonomy Name | Nurse's Aide
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 172A00000X
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Taxonomy Name | Driver
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License Number |
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License Number State |
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