MEDICARE: PEACE HOME CARE INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	310400000X	Assisted Living Facility	8952

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1053598482
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PEACE HOME CARE INC

Provider Business Mailing Address
First Line	:	5040 NW 197TH ST
Second Line	:
City	:	MIAMI GARDENS
State	:	FL
Zip	:	33055-1751
Country	:	US
Telephone Number	:	305-621-4213
Fax Number	:

Provider Business Practice Location Address
First Line	:	5040 NW 197TH ST
Second Line	:
City	:	MIAMI GARDENS
State	:	FL
Zip	:	33055-1751
Country	:	US
Telephone Number	:	305-621-4213
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MRS. ANA L ABREU
Credential	:
Telephone Number	:	305-621-4213

Provider Enumeration Date	:	01/28/2008
Last Update Date	:	01/28/2008

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Directions to “PEACE HOME CARE INC ” Practice Location

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