Provider Demographics
NPI:1396567061
Name:HABY PEACE AT HOME LLC
Entity type:Organization
Organization Name:HABY PEACE AT HOME LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:HADJE
Authorized Official - Middle Name:ACHTA
Authorized Official - Last Name:BOUKARI NAYA
Authorized Official - Suffix:
Authorized Official - Credentials:MASTERS OF EDUCATION
Authorized Official - Phone:573-825-5024
Mailing Address - Street 1:3830 S COUNTRY WOODS RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MO
Mailing Address - Zip Code:65203-9510
Mailing Address - Country:US
Mailing Address - Phone:573-825-5024
Mailing Address - Fax:
Practice Address - Street 1:3830 S COUNTRY WOODS RD
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MO
Practice Address - Zip Code:65203-9510
Practice Address - Country:US
Practice Address - Phone:573-825-5024
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-24
Last Update Date:2024-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities
No251C00000XAgenciesDay Training, Developmentally Disabled Services