Provider Demographics
NPI:1205168085
Name:PEACE OF HEART IN-HOME CARE LLC
Entity type:Organization
Organization Name:PEACE OF HEART IN-HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:RACHEL
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:LUCKI
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:570-732-4500
Mailing Address - Street 1:29 BEHRENS ROAD
Mailing Address - Street 2:
Mailing Address - City:JIM THORPE
Mailing Address - State:PA
Mailing Address - Zip Code:18229-9536
Mailing Address - Country:US
Mailing Address - Phone:570-732-4500
Mailing Address - Fax:
Practice Address - Street 1:29 BEHRENS RD
Practice Address - Street 2:
Practice Address - City:JIM THORPE
Practice Address - State:PA
Practice Address - Zip Code:18229-9536
Practice Address - Country:US
Practice Address - Phone:570-732-4500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-04
Last Update Date:2010-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251C00000XAgenciesDay Training, Developmentally Disabled Services