Provider Demographics
NPI:1780820910
Name:PEACE, INC
Entity Type:Organization
Organization Name:PEACE, INC
Other - Org Name:GRACE FAMILY HOME CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:STACEY
Authorized Official - Middle Name:L
Authorized Official - Last Name:FUHRMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:727-259-2337
Mailing Address - Street 1:7411 114TH AVE STE 303
Mailing Address - Street 2:
Mailing Address - City:LARGO
Mailing Address - State:FL
Mailing Address - Zip Code:33773-5108
Mailing Address - Country:US
Mailing Address - Phone:727-259-2337
Mailing Address - Fax:727-210-0682
Practice Address - Street 1:7411 114TH AVE STE 303
Practice Address - Street 2:
Practice Address - City:LARGO
Practice Address - State:FL
Practice Address - Zip Code:33773-5108
Practice Address - Country:US
Practice Address - Phone:727-259-2337
Practice Address - Fax:727-210-0682
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-17
Last Update Date:2023-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLHHA299993353251E00000X
251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL000810800Medicaid
FL014250500Medicaid
FL109406Medicare PIN