Provider Demographics
NPI:1275911653
Name:PEACE FROM PIECES
Entity Type:Organization
Organization Name:PEACE FROM PIECES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RESIDENT COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:PAMELA
Authorized Official - Middle Name:ROSETTA
Authorized Official - Last Name:WILSON
Authorized Official - Suffix:
Authorized Official - Credentials:RESIDENT COUNSELOR
Authorized Official - Phone:240-478-2727
Mailing Address - Street 1:PO BOX 1473
Mailing Address - Street 2:
Mailing Address - City:HOPEWELL
Mailing Address - State:VA
Mailing Address - Zip Code:23860-1473
Mailing Address - Country:US
Mailing Address - Phone:240-478-2727
Mailing Address - Fax:240-595-6187
Practice Address - Street 1:307 LAFAYETTE BLVD STE 202
Practice Address - Street 2:
Practice Address - City:FREDERICKSBURG
Practice Address - State:VA
Practice Address - Zip Code:22401-6079
Practice Address - Country:US
Practice Address - Phone:240-478-2727
Practice Address - Fax:240-595-6187
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-18
Last Update Date:2019-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization