Provider Demographics
NPI:1487224366
Name:PASSION FOR PEACE
Entity Type:Organization
Organization Name:PASSION FOR PEACE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER/THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:JAIRUS
Authorized Official - Middle Name:
Authorized Official - Last Name:ROBINSON
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:404-202-0056
Mailing Address - Street 1:1878 WESTON LN
Mailing Address - Street 2:
Mailing Address - City:TUCKER
Mailing Address - State:GA
Mailing Address - Zip Code:30084-5500
Mailing Address - Country:US
Mailing Address - Phone:404-860-0840
Mailing Address - Fax:
Practice Address - Street 1:1878 WESTON LN
Practice Address - Street 2:
Practice Address - City:TUCKER
Practice Address - State:GA
Practice Address - Zip Code:30084-5500
Practice Address - Country:US
Practice Address - Phone:404-860-0840
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-01
Last Update Date:2021-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)