MEDICARE: PEACE AT HOME HOME CARE SERVICES, LLC

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	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1356206577
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PEACE AT HOME HOME CARE SERVICES, LLC

Provider Business Mailing Address
First Line	:	31 BOLAND CT
Second Line	:
City	:	GREENVILLE
State	:	SC
Zip	:	29615-5730
Country	:	US
Telephone Number	:	864-767-6197
Fax Number	:	864-767-6196

Provider Business Practice Location Address
First Line	:	31 BOLAND CT
Second Line	:
City	:	GREENVILLE
State	:	SC
Zip	:	29615-5730
Country	:	US
Telephone Number	:	864-767-6197
Fax Number	:	864-767-6196

Authorized Official
Title or Position	:	ADMINSTRATOR
Name	:	KRYSTAL DAVIS
Credential	:
Telephone Number	:	864-237-7950

Provider Enumeration Date	:	12/19/2025
Last Update Date	:	12/19/2025

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