MEDICARE: PERFECT 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	251E00000X	Home Health Agency		MI

General Provider Information

NPI Number	:	1912183757
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PERFECT PEACE HOME CARE, INC.

Provider Business Mailing Address
First Line	:	PO BOX 334
Second Line	:
City	:	LINCOLN PARK
State	:	MI
Zip	:	48146-0334
Country	:	US
Telephone Number	:	313-424-0316
Fax Number	:

Provider Business Practice Location Address
First Line	:	1069 S DEACON ST
Second Line	:
City	:	DETROIT
State	:	MI
Zip	:	48217-1610
Country	:	US
Telephone Number	:	313-424-0316
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR
Name	:	MRS. LESLIE ANN HILL
Credential	:
Telephone Number	:	313-424-0316

Provider Enumeration Date	:	01/10/2008
Last Update Date	:	01/10/2008

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