Provider Demographics
NPI:1568097723
Name:PEACE AT LAST PRIVATE HOME CARE LLC.
Entity Type:Organization
Organization Name:PEACE AT LAST PRIVATE HOME CARE LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:NAKESHA
Authorized Official - Middle Name:
Authorized Official - Last Name:MCMINNS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:470-246-5522
Mailing Address - Street 1:5596 MAYFAIR CROSSING DR
Mailing Address - Street 2:
Mailing Address - City:LITHONIA
Mailing Address - State:GA
Mailing Address - Zip Code:30038-1182
Mailing Address - Country:US
Mailing Address - Phone:770-905-3544
Mailing Address - Fax:
Practice Address - Street 1:5596 MAYFAIR CROSSING DR
Practice Address - Street 2:
Practice Address - City:LITHONIA
Practice Address - State:GA
Practice Address - Zip Code:30038-1182
Practice Address - Country:US
Practice Address - Phone:770-905-3544
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-09
Last Update Date:2020-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes253Z00000XAgenciesIn Home Supportive CareGroup - Multi-Specialty
No163WC0400XNursing Service ProvidersRegistered NurseCase ManagementGroup - Multi-Specialty
No372600000XNursing Service Related ProvidersAdult CompanionGroup - Multi-Specialty
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Multi-Specialty
No376J00000XNursing Service Related ProvidersHomemakerGroup - Multi-Specialty