Provider Demographics
NPI:1942559968
Name:HELEN'S PEACE HOME HEALTHCARE, LLC
Entity Type:Organization
Organization Name:HELEN'S PEACE HOME HEALTHCARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ ADMINISTRATOR
Authorized Official - Prefix:MISS
Authorized Official - First Name:DEMETRIA
Authorized Official - Middle Name:DESHON
Authorized Official - Last Name:LUCKETT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-516-8983
Mailing Address - Street 1:6111 KENILWOOD DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77033-1223
Mailing Address - Country:US
Mailing Address - Phone:832-516-8983
Mailing Address - Fax:
Practice Address - Street 1:6111 KENILWOOD DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77033-1223
Practice Address - Country:US
Practice Address - Phone:832-516-8983
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-05
Last Update Date:2012-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home