Provider Demographics
NPI:1003204751
Name:PEACE HOMECARE, LLC.
Entity Type:Organization
Organization Name:PEACE HOMECARE, LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PAULETTA
Authorized Official - Middle Name:LINDA
Authorized Official - Last Name:HARRELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:405-431-0699
Mailing Address - Street 1:202 N. UNIVERSITY BLVD.
Mailing Address - Street 2:
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73069
Mailing Address - Country:US
Mailing Address - Phone:405-701-5951
Mailing Address - Fax:405-701-5953
Practice Address - Street 1:202 N. UNIVERSITY BLVD.
Practice Address - Street 2:PEACE HOMECARE, LLC.
Practice Address - City:NORMAN
Practice Address - State:OK
Practice Address - Zip Code:73069
Practice Address - Country:US
Practice Address - Phone:405-701-5951
Practice Address - Fax:405-701-5953
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PEACE HOMECARE, LLC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-01-05
Last Update Date:2015-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKHC8024253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care