Provider Demographics
NPI:1578923140
Name:PEACE AT HOME IN-HOME CARE LLC
Entity Type:Organization
Organization Name:PEACE AT HOME IN-HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KATHERINE
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:GOODRICH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:757-647-3306
Mailing Address - Street 1:1485 MOONLIGHT RD
Mailing Address - Street 2:
Mailing Address - City:SMITHFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:23430-1963
Mailing Address - Country:US
Mailing Address - Phone:757-647-3306
Mailing Address - Fax:
Practice Address - Street 1:1485 MOONLIGHT RD
Practice Address - Street 2:
Practice Address - City:SMITHFIELD
Practice Address - State:VA
Practice Address - Zip Code:23430-1963
Practice Address - Country:US
Practice Address - Phone:757-647-3306
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-25
Last Update Date:2016-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care