MEDICARE: PEACE AT HOME BEHAVIORAL SERVICES PLLC

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	103K00000X	Behavior Analyst

General Provider Information

NPI Number	:	1639025851
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PEACE AT HOME BEHAVIORAL SERVICES PLLC

Provider Business Mailing Address
First Line	:	3914 E HIDDENVIEW DR
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85048-7343
Country	:	US
Telephone Number	:	480-930-1615
Fax Number	:

Provider Business Practice Location Address
First Line	:	3914 E HIDDENVIEW DR
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85048-7343
Country	:	US
Telephone Number	:	480-930-1615
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	AMYLLEN L EVANS
Credential	:	MS, BCBA, LBA
Telephone Number	:	480-930-1615

Provider Enumeration Date	:	03/09/2026
Last Update Date	:	03/09/2026

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