Provider Demographics
NPI:1598368649
Name:PEACE HEALTH CARE SERVICES LLC
Entity Type:Organization
Organization Name:PEACE HEALTH CARE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:HARON
Authorized Official - Middle Name:K
Authorized Official - Last Name:ORUTWA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:201-253-6262
Mailing Address - Street 1:582 W SIDE AVE
Mailing Address - Street 2:
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07304-1718
Mailing Address - Country:US
Mailing Address - Phone:201-253-6262
Mailing Address - Fax:
Practice Address - Street 1:582 W SIDE AVE
Practice Address - Street 2:
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07304-1718
Practice Address - Country:US
Practice Address - Phone:201-253-6262
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-20
Last Update Date:2021-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service