Provider Demographics
NPI:1255028973
Name:GAQ INNER PEACE PSYCHIATRY
Entity type:Organization
Organization Name:GAQ INNER PEACE PSYCHIATRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PMHNP/ OWNER
Authorized Official - Prefix:
Authorized Official - First Name:QUEENDROLINE NKEH
Authorized Official - Middle Name:
Authorized Official - Last Name:NKEH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:240-486-8941
Mailing Address - Street 1:1700 S 1ST AVE STE 25A
Mailing Address - Street 2:
Mailing Address - City:IOWA CITY
Mailing Address - State:IA
Mailing Address - Zip Code:52240-6036
Mailing Address - Country:US
Mailing Address - Phone:319-775-5410
Mailing Address - Fax:
Practice Address - Street 1:1700 S 1ST AVE STE 25A
Practice Address - Street 2:
Practice Address - City:IOWA CITY
Practice Address - State:IA
Practice Address - Zip Code:52240-6036
Practice Address - Country:US
Practice Address - Phone:319-775-5410
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-21
Last Update Date:2025-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No261QA0005XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Family Planning Facility