Provider Demographics
NPI:1225755580
Name:PEACE HOME HEALTH CARE LLC
Entity Type:Organization
Organization Name:PEACE HOME HEALTH CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LAE
Authorized Official - Middle Name:
Authorized Official - Last Name:LOE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:414-394-3896
Mailing Address - Street 1:5252 N 66TH ST
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53218-3012
Mailing Address - Country:US
Mailing Address - Phone:414-394-3896
Mailing Address - Fax:
Practice Address - Street 1:5252 N 66TH ST
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53218-3012
Practice Address - Country:US
Practice Address - Phone:414-394-3896
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-26
Last Update Date:2022-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care